NDD-MS Flashcards
T or F: The exact cause of MS is known.
False, it is unknown - current research has suggested that an environmental factor or viral infection triggers an autoimmune response in people who are genetically susceptible.
T or F: Men are affected with MS more than women are.
False, women are affected more than me by a ratio of almost 3:1
What areas should early intervention for MS focus on in order to prevent and delay onset of disability?
Functional mobility, ADLS, fatigue management, and role and routine modifications
T or F: MS typically is diagnosed later in life.
False, it is the most frequently diagnosed neurological condition that can cause disability in young adults, most often ages 20-40 years.
What is MS?
Chronic, often progressive demyelinating disease of the CNS where the person’s own body attacks the myelin sheath that covers the neurons of the brain and spinal cord. This demyelination produces scar tissue or plaque (sclerosis) on the myelin sheath of nerve fibers that interferes with the axons’ ability to conduct impulses. The result is impaired nerve conduction and inflammation, which causes neurological dysfunction.
T or F: The specific location of demyelination is the same in each person with MS.
False, it is different from person to person and it dictates symptoms.
What are some initial complaints of MS?
typically visual disturbances, dizziness, and weakness. Symptoms at times worsen (exacerbation) and at other times improve (remission).
T or F: MS progresses over time and is eventually irreversible.
True
What are some motor symptoms of MS?
Impaired balance and coordination (ataxia), partial or complete paralysis of a part of the body, muscle spasticity (especially in lower extremities), muscle weakness, fatigue, intention tremors, and dysphagia
What is the most common complaint and debilitating symptom of MS?
Fatigue
What motor symptom of MS occurs when a person attempts to engage in meaningful activity such as reaching for an object?
Intention tremors
What are some sensory symptoms associated with MS?
parasthesia, vertigo and pain
What is parasthesia?
numbness or tingling
Impaired sensations, which may affect perceptual skills such as stereognosis, kinesthesia or body scheme is known as what kind of sensory symptom associated with clients with MS?
paresthesia
T or F: Distorted superficial sensation is known as pain.
False, it’s paresthesia
Impaired vibratory, proprioceptive, pain, touch and temperature sensations are known as what kind of sensory symptom associated with clients with MS?
paresthesia
What are some visual symptoms associated with clients with MS?
diplopia, blurred or dimmed vision (with or without ocular pain) and optic neuritis
What is the term for double vision?
diplopia
What causes sudden loss of vision with pain in or behind the eye, with symptoms possibly subsiding after 3-6 weeks without residual impairments?
optic neuritis
What is known as partial loss of vision?
scotoma
Nystagmus is part of which visual symptom associated with MS?
optic neuritis
T or F: Optic neuritis accounts for loss of visual activity in 80% of people with MS.
True
Scotoma is associated with which visual symptom of MS?
Optic neuritis
What are some communication symptoms of MS?
Slurred speech, scanning speech
What is scanning speech?
slow enunciation with frequent hesitations at the beginnings of words or syllables
What is incontinence or urinary retention?
failure to empty the bladder
T or F: Individuals with MS may experience increased urgency or frequency, as well as constipation.
True
Men with MS may experience what sexual symptom?
erectile dysfunction
Women with MS may experience what sexual symptoms?
decreased libido, lubrication difficulty, and inorgasmia, but ability to conceive and carry pregnancy to terms remains intact
What are some cognitive symptoms associated with MS?
short term memory loss, attention deficits, decreased processing speed, impairment in visuospatial ability, impaired executive functioning and judgement, difficulty with attention, conceptualization, memory or new learning, difficulty with abstract reasoning and problem solving as well as difficulty with tasks that require either rapid or precise motor responses.
T or F: Depression may occur in patients with MS
True
T or F: Depression is known to be a manifestation of the neurological condition.
False, it is uncertain if depression is a manifestation of the condition or a reaction to the disease
T or F: Inappropriate euphoria is not associated with MS.
False, it is associated with MS
T or F: Lability is an emotional symptom associated with MS
True (lability is uncontrollable episodes of crying or laughing, rapidly changing emotions)
What are some factors that must be present to contribute to a diagnosis of MS?
episodes of exacerbation and remission and slow or step by step progression over six months, there must also be evidence of lesions in more than one site in the white matter and no other neurological explanation for the clinical picture
T or F: Diagnostic tests for MS may include cerebrospinal fluid analysis, nerve conduction studies, and brain imaging such as MRI or CAT scans.
True
T or F: MS disease course is predictable and a similar prognosis.
False, it is unpredictable and prognosis varies drastically
T or F: There is a cure for MS
False, there is no cure or treatment that eliminates the disease
What is the goal of medical and rehab treatment for clients with MS?
To minimize the severity, amount and length of exacerbations in order to improve function.
What defines the progressive state of relapse-remitting?
fluctuating course of relapses with associated neurologic deficits, followed by periods of relative quiet
What defines the progressive state of MS known as secondary progressive?
cessation of fluctuations with slow deterioration
What defines the progressive state of MS known as secondary progressive with relapses?
fluctuation with relapses and deterioration between relapses
What defines the progressive state of MS known as primary progressive?
deterioration from beginning
What defines the progressive state of MS known as progressive relapsing?
progressive with relapses
T or F: MS is occasionally described as either benign or malignant
True
How long after onset do patients with benign MS show functional limitations?
15 years
T or F: Malignant MS progresses rapidly, causing significant disability or death in a short period.
True
T or F: The most often prescribed medications for MS include antispasmodics, muscle relaxants and anticonvulsants
True
T or F: Steroids are not prescribed for patients with MS
False, they are occasionally prescribed, more often in acute stages and only for temporary use.
T or F: There are surgical options for clients with MS.
False, there are none
T of F: You would use the modifed ashworth scale for spasticity for clients with MS
True
What are some standardized eval tools an OT can use with clients with MS?
Modified fatigue impact scale, beck depression inventory-18, FIM, nine hole peg test or purdue pegboard test for manual dexterity and fine motor coordination, seemes-weinstein monofilament testing for sensory function, modified ashworth scale for spasticity
T or F: Clients with MS typically experience varied amounts of strength and endurance throughout the day depending on participation in occupations and timing of medications
True
T or F: Goals should address both the exacerbation and remission stages and should be compensatory because of the progressive nature of MS
True
What are some contraindications to intervention for clients with MS?
hot temperatures, heat modalities such as moist heat or fluidotherapy, increased emotional or physical stress, excessive physical activity or overexertion, alcohol use increased balance deficits and can be dangerous when mixed with medications used to treat the symptoms of MS.
T or F: You should maintain hips at 90 degrees or more of flexion to reduce extensor tone in the lower extremities for clients with MS
True
T or F: Fatigue is always the same; there is only one type.
False, there are multiple types of fatigue
Which fatigue is characterized as a direct results of the MS disease process?
primary MS fatigue
Which fatigue is can be caused from spasticity, depression or bowel and bladder issues?
fatigue secondary to sleep disturbances
Which fatigue is likely the result of poor nerve conduction?
nerve fiber or motor fatigue
T or F: Fatigue can be secondary to depression or mood changes, from muscle weakness or spasticity or related to medication side effects or infection.
True
In order to help a client overcome weakness in dorsiflexion you should..
use appropriate equipment such as an ankle-foot orthosis
Clients with MS have weakness with which foot movement: plantar flexion or dorsiflexion
dorsiflexion
T or F: You should use heat as modality with client with MS.
False, use ice
T or F: You should instruct a client with MS on cooling techniques
True
T or F: When working on ataxia, it is best to encourage distal stabilization to improve proximal movements.
False, it is best to encourage proximal stabilization for improved distal movements.
T or F: The use of a cervical collar is not needed for clients with MS.
False, cervical collar helps to reduce the travel of the head and neck
T or F: clients with MS would not benefit from a wrist splint
False, wrist splints are used to minimize travel and number of joints in motion in the presence of a tremor
T or F: Only allow a SLP to assess swallow with patients with MS.
False, it is best to collaborate with a SLP to enhance intervention strategies and carryover. Routinely screen for signs of choking, aspiration or swallowing dysfunction since most people with MS who are asymptomatic have underlying impairments.
T or F: Emotional and physical stress can temporarily worsen symptoms with individuals with MS.
True, hence why it is important to teach stress management and relaxation techniques
T or F: Coping strategies can be used to help patients with MS handle exacerbations.
True
T or F: Maintaining hip extension decreases extensor spasm.
False, maintaining hip flexion decreases extensor spasm
What are some ADL adaptations you could recommend for a patient with MS?
built up handles, reachers and sock donners to compensate for weak muscles and maintain joint integrity, weighted utensils for feeding or wrist weights during self-care activities to reduce tremors, AE or stool for LBD and LB bathing.
