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Kol- 410 Med Surg II > MS / ALS > Flashcards

MS / ALS Flashcards

1
Q

3 characteristics of MS

A

chronic
autoimmune
demyelination –> plaques in CNS white matter

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2
Q

why does myelin matter? what do you see with demyelination?

A

myelin allows transfer of nervous signal through body

without it = stop or slow impulse

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3
Q

Trur of False:

with MS once you lose myelin its gone forever

A

False

remyelination can occur but is *incomplete *

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4
Q

which cells cause demyelination with MS

A

Th-cells and B-cells

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5
Q

4 types of MS

A
  1. Relapsing Remitting MS (RRMS)
  2. Primary Progressive MS (PPMS)
  3. Secondary Progressive MS (SPMS) (combine 1 and 2 types)
  4. Progressive Relapsing
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6
Q

match with the type of MS

-S&S develop and resolve over weeks to months
-Flare that Returns to baseline
-Most cases MS

A

Relapsing Remitting MS (RRMS)

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7
Q

match with the type of MS

-Small percentage
-Frequent relapse with partial recovery
-NO return to baseline

A

progressive relapsing

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8
Q

match with the type of MS

  • no remission, no acute attacks
  • gradual progression
  • onset 40-60 years
A

Primary Progressive MS (PPMS)

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9
Q

type of ms:

Often begins as Relapsing Remitting then becomes Progressive

A

Secondary Progressive MS (SPMS)
(combine 1 and 2 types)

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10
Q

causes of MS + frequency

A

genetics, immune, enviro

women > men
cold areas

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11
Q

s/s of MS re: mobility changes

A

Tremor
Fatigue
Spasticity

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12
Q

s/s of MS re: muscle weakness

A

Dysarthria
Dysphagia
Gait disturbances
Flaccid or spastic bladder or bowel

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13
Q

s/s MS re: visual changes

A

Decreased visual acuity and perception
Nystagmus
Blurred vision
Double Vision

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14
Q

s/s of MS re: cognition changes

A

Inattention
Memory issues
Problem solving difficulties
Alteration in reasoning

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15
Q

general s/s of MS:

A

-pain
-mobility changes
-muscle weakness
-parasthesia
-visual changes
-cognition changes

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16
Q

3 main complications from MS

A
  1. infection (aspiration pneuminia, UTI)
  2. immobilty (OP/ pressure injury)
  3. Depression

-Dysphagia–> Aspiration pneumonia
-Bladder retention –> UTI and Urosepsis

17
Q

diagnostics for MS

A

-clinical presentation
-LP
-MRI
-EMG
-Evoked Potential Testing or Visual Evoked Response

18
Q

what is Evoked Potential Testing or Visual Evoked Response?

A

test for ms :
-Non-invasive
-Evaluates transmission along optic nerve pathway

19
Q

factors that can make MS worse

A

-Fatigue
-Stress
-Overexertion
-Temperature extremes (hot bath, shower, cold weather…)

20
Q

what concerns do we have with MS patient eating?

A

aspiration! assess for dysphagia

21
Q

interventions for MS are focused on…

A

-Prevent exacerbations
-Manage symptoms
-Optimize function
-Alter effects on immune system

aka keep from getting sick and improve quality of life

22
Q

what kind of exercise do people with MS need to avoid? what should they do?

A

AVOID : rigorous activity/exercise and hyperthermia

DO: ROM, stretching, rest, strengthening

23
Q

bladder interventions for MS

A
  • self-cath
  • bladder pacemaker
24
Q

SEE BOOK FOR SPECIFIC DRUG STUFF

A

hint hint… maybe ill remember to make cards for this later

25
Q

general drug stuff for MS: what are we giving?

A
  • NSAIDS
  • Immunomodulators
  • Interferon-beta
  • Antispasmodics
    –>Intrathecal Baclofen
26
Q

characteristics of ALS

A
  • chronic
  • progressive
  • fatal
  • lose control of voluntary muscle
27
Q

2 types of ALS

A
  • familial
  • sporadic (more common)
28
Q

patho of ALS

A

JK its too complicated, i aint a doctor

29
Q

cause of ALS

A

mystery
genetics, enviro

30
Q

s/s of ALS

A

-Uncontrollable laughing or crying
-Fatigue
-Muscle cramps
-Muscle weakness and atrophy
-Twitching
-Stiff-clumsy gait
-Dysarthria
-Dysphagia
-Abnormal reflexes

31
Q

what systems does ALS not effect?

A

sensory or bladder

both of these effected in MS

32
Q

top complications from ALS

A
  1. death in 2-5 years
  2. immbolity (falls, pressure injury)
  3. Respiratory (trach/vent, bipap, failure, aspiration pneumonia )
33
Q

diagnostics for
ALS

A

by rule out
- do all the usual neuro tests

34
Q

interventions for ALS focused at …

A

slow progression, optimize function, ensure comfort

35
Q

special resp intervention for ALS that is placed in the client

A

Diaphragm Pacer

  • In ALS, diaphragm pacing isprimarily intended to achieve muscle conditioning by taking advantage of the heterogeneous muscle involvement in this disease
36
Q

drugs for als that increases life expectancy by 3-5 months

A

Riluzole (Rilutek)

37
Q

other drugs for ALS (not sure if we need to know these?)

A
  • Edaravone (Radicava)  IV agent. Effects unknown at this time.
  • Dextromethorphan and Quinidine Sulfate (Nuedexta)
  • Tiglutik (thickened Riluzole)
  • Exservan (Riluzole film)
38
Q

ways to improve communication for ALS patients?

A

eye tracking boards, communication boards

Kol- 410 Med Surg II (27 decks)

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