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NEC 3 > MULTIPLE SCLEROSIS > Flashcards

MULTIPLE SCLEROSIS Flashcards

1
Q

multiple sclerosis occurs in what age?

A

ages 20 and 40 years

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1
Q

Define multiple sclerosis

A

-a chronic, unpredictable progressive, degenerative disorder of the CNS

-disseminated demyelination of nerve fibers of the brain and spinal cord

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2
Q

Etiology of Multiple Sclerosis

A

-idiopathic
-autoimmune
- viral exposure

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3
Q

the result of autoimmune in the etiology of multiple sclerosis is because of _____

A

-driven by activated T cells

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4
Q

T cells can cause_____

A

T cells can cause inflammation and demyelination and destruction

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5
Q

What is the Pathophysiology of Multiple Sclerosis?

A

-immune system attacks on the myelin protein
-slowed transmission of nerve impulses
- 3 process (chronic inflammation, demyelination and gliosis)
-recurrence destroys oligodendrocytes
- further damage to underlying axon
- disruption of nerve impulse transmission
- loss of nerve function
- hard, rigid plaque formation
- atrophy of cerebral cortex

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6
Q

Gliosis is a

A

-scar formation
- a fibrous proliferation of glial cells

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7
Q

a fibrous proliferation of glial cells

A

Gliosis

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8
Q

Clinical Manifestations of Multiple Sclerosis

A

-First sign of MS
- coordination and balance problems
- extremity muscle weakness
-partial or complete paralysis
- numbness and tingling
- LHERMITTE’S SIGN
- MS HUG
- Cerebellar Signs

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9
Q

What is the first sign of MS (Multiple Sclerosis)?

A

-blurred or double vision
- red-green color distortion
-blindness in 1 eye

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10
Q

What is Lhermitte’s sign?

A

a temporary sensory symptoms described as an electric shock going to the spine or into the limbs with neck flexion

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11
Q

What is MS HUG?

A

-pain around the low thoracic and abdominal regions
- muscle spasm in intercostal and abdominal muscles

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12
Q

What are the cerebellar signs?

A

-nystagmus
- ataxia
- dysarthria
- dysphagia

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13
Q

what is nystagmus?

A

involuntary eye movement

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14
Q

what is ataxia?

A

loss of muscle control

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15
Q

what is dysarthria?

A

difficulty in speaking

16
Q

what is dysphagia?

A

difficulty swallowing

17
Q

other clinical manifestations of multiple sclerosis

A

-hearing loss
-tremors
-dizziness
-constipation
-spastic bladder
- flaccid (hypertonic) bladder
- erectile dysfunction
- decreased libido
- anger & depression

18
Q

Diagnostic Studies of Multiple Sclerosis

A

-MRI with contrast of the brain and spinal cord
-CSF analysis

19
Q

Show plaques, inflammation, atrophy and tissue

A

MRI with contrast of the brain and spinal cord

20
Q

The diagnostic criteria for MS

A
  1. evidence of at least 2 inflammatory demyelinating lesions in at least 2 different locations within the CNS.
  2. two or more attacks occurring at different times (usually 1 month or more apart)
  3. all other diagnosis ruled out
21
Q

Medical Management of MS

A

-Immunomodulator Drugs
- Disease- modifying drugs
-Corticosteroids

22
Q

What is the mechanism of action of the immunomodulator drugs?

A

modify the response of the immune system by increasing or decreasing the production of serum antibodies

23
Q

What are the immunomodulator drugs?

A

-interferon B-1 a (renif, plegridy)
- interferon B-1b (betaseron)
- glatiramer acetate (copaxone)

24
Q

Drug alert of B-interferon

A

-assess for depression and suicidal thoughts
- teach patient to wear sunscreen and protective clothing when exposed to sun
- tell the patient that flu-like symptoms are common after starting therapy.

25
Q

What is the mechanism of action of the disease-modifying drugs (DMOs)?

A

-immunosuppressant
-modify disease progression and prevent relapses
- more effective if started early
- given after immunomodulators

26
Q

what are the disease-modifying drugs?

A

-interferons
- monoclonal antibodies
- synthetic agents

27
Q

mechanism of action of the corticosteroids

A

-reduce edema and acute inflammation at the site of demyelination and speed recovery

28
Q

Examples of corticosteroids in MS

A

prednisone

29
Q

Nursing Management of Multiple Sclerosis

A

-Maximize neuromuscular function
- Maintain independence in activities of daily living
- Watch out for complications of immobility like respiratory complications, UTIs, and pressure injuries
- High fiber diet for constipation is common.
- Promotion of exercise for spasticity (rigidity of muscles)

NEC 3 (16 decks)

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