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B3 - MS > Neuro + Autoimmune > Flashcards

Neuro + Autoimmune Flashcards

1
Q

Multiple sclerosis

A

Demyelinating disease (destruction of myelin)

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2
Q

Parkinson’s disease

A

Decreased availability of dopamine

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3
Q

Myasthenia gravis

A

Impaired acetylcholine binding to muscle cells

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4
Q

Acetylcholine

A

Usually excitatory -

Major transmitter of the parasympathetic nervous system

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5
Q

Dopamine

A

Usually inhibitory-

Affects behavior + fine movements

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6
Q

MS

Signs+ symptoms

A 
Fatigue (most debilitating)
Pain
Spasticity
Cognitive changes (memory changes + decreased concentration)
Ataxia + tremor
Emotional lability + euphoria
Bladder, bowel, + sexual dysfunction
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7
Q

Complications with MS

A 
UTI
constipation
pressure ulcers
contractures
dependent edema
pneumonia
osteoporosis
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8
Q

Uhthoff’s Sign / Phenomenon

A

Worsening MS s/sx with an increase intemp.

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9
Q

Lhermitte’s sign

A

Electrical shock sensation moves down neck into spine

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10
Q

Romberg sign (cerebellar)

A

Standing w/ eyes closed, feet together + they sway or fall

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11
Q

Fatigue

r/t MS

A

Most debilitating symptom

Contributing factors - heat, depression, anemia, deconditioning, + medication

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12
Q

Pain

r/t MS

A

Contributes to social isolation

Caused by lesions on sensory pathways- paresthesia, dysesthesias, proprioception loss

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13
Q

Dysesthesias

A

Abnormal sensation

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14
Q

Spasticity

r/t MS

A

90% of PTs

Most often in LE + include loss of abd reflexes

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15
Q 
Cognitive changes
(r/t MS)
A

Memory loss + decreased concentration

Occur in about half of PTs

Severe cognitive changes w/ dementia rare.

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16
Q

Ataxia + tremor

r/t MS

A

Ataxia - Impaired coordination + movements

d/t involvement of cerebellum or basal ganglia

17
Q

Emotional lability + euphoria
AND
Bladder, bowel, + sexual dysfunction
(r/t MS)

A

From loss of the control connections between cortex + basal ganglia

Incl. overactive bladder or trouble contracting to void

18
Q

Diagnosis of MS

A

Evidence of damage in at least two separate areas of the central nervous system (CNS)
AND
Evidence that the damage occurred @ different points in time
AND
Rule out all other possible diagnoses

There are no symptoms, physical findings, or lab tests that can - by themselves- diagnose MS

19
Q

After lumbar puncture, the CSF must be…

A

Hand carried to the lab

20
Q

MS

A

There is NO cure for MS

21
Q

MS - Disease-modifying meds…

A

Reduce frequency of relapse, duration of relapse + number and size of plaques seen on MRI in the RR form of MS

Not effective in the primary progressive form of MS

Interferon - Refib/Betaseron + Avonex
copaxone
Teriflunomide/fingolimod
dimethyl fumarate
mitoxantrone
22
Q

MS- symptom management meds

A
  • Baclofen, tizanidine, dantrolene (muscle relaxants/antispasmodics)
  • Amantadine (dopamine promoter)
  • Pemoline (stimulant)
  • Dalfampridine (muscle strengthener) -Oxybutynin (Ditropan) (anticholinergic for urinary incontinence, relaxes bladder muscle to prevent contractions)
  • Bethanechol (Urecholine) (cholinergic for neurogenic bladder, helps empty bladder)
23
Q

Patients w/ MS are at risk for…

A

Aspiration

d/t swallowing difficulties

24
Q

Myasthenia gravis (MG) is….

A

Purely a motor disorder -

No effect on sensation or coordination

25
Q

Medication contraindicated in PTs diagnosed w/ MS

A

Novocaine

  • metabolized slowly, increased risk of toxicity
26
Q

Mestinon

A

anticholinesterase medication -

inhibits breakdown of acetylcholine and increasing the relative concentration of available ACh at the neuromuscular junction –

dose gradually increased to daily maximum and given in divided doses (QID) –

adverse effects include diarrhea, abd cramps, and/or excessive saliva –

Mestinon has the fewest SEs.

MUST TAKE TO PREVENT MYASTHENIC CRISIS

27
Q

Nursing considerations for myasthenia gravis med management

A

Maintenance of stable blood levels of anticholinesterase meds is imperative to stabilize muscle strength

Must be given on time - delays may exacerbate muscle weakness + make it impossible for the PT to take meds orally

B3 - MS (3 decks)

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