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KN JD NPTE: NM > NM Multiple Sclerosis > Flashcards

NM Multiple Sclerosis Flashcards

1
Q

Chronic, degenerative, _________ disease of CNS

A

Demyelinating

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2
Q

Etiology is unknown but likely _____, _________

A

Viral, autoimmune

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3
Q

Demyelinating lesions (________) impair neural transmissions, so nerves ______ ______

A

Plaque

Fatigue fast

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4
Q

Where are the lesions common?

A

Pyramidal tract
Dorsal columns
Periventricular areas of cerebrum
Cerebellar peduncles

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5
Q

Precipitating/exacerbating factors include what 4 things?

A

Infection
Trauma
Pregnancy
Stress

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6
Q 
Transient worsening symptoms =
Adverse reaction to \_\_\_\_\_
\_\_\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_\_
A

Heat
Dehydration
Hyperventilation
Fatigue

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7
Q

What is the most common type?

A

RRMS

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8
Q

What is relapsing remitting MS? (RRMS)

A

Discrete attacks of relapses with either full or partial remissions in subsequent weeks/months

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9
Q

What is primary progressive MS? (PPMS)

A

Disease progression and deterioration in function from onset
Modest fluctuation in Neuro disability
NO DISCRETE ATTACKS

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10
Q

What is secondary progressive MS (SPMS)?

A

Starts off as RRMS but then changes to PPMS, with or without continued acute attacks

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11
Q

What is progressive relapsing MS (PRMS)?

A

Steady deterioration with acute attacks occasionally

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12
Q

What is clinically isolated syndrome?

A

1st episode of inflammatory demyelination in the CNS that could become MS if more activity occurs
Can progress to RRMS

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13
Q

What Dx tests would you do?

A

LP/CSF — would show increased gamma globulin
CT/MRI
Myelogram
EEG

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14
Q

Exam includes:

1) History
2) Cog/affective status — what are you looking for?

A

Mild-mod cog impairment common; euphoria, emotional dysregulation

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15
Q

Exam includes:

3) Communication — what are you looking for?

A

Dysarthria
Scanning speech
Dysphasia

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16
Q

Exam includes:

4) ROM/deformity: associated with ____

A

Disuse

17
Q

Exam includes:

5) sensation: what are you looking for?

A 
Parasthesias
Hyperpathia
Dysesthesia
Trigeminal neuralgia
Lhermitte’s sign
18
Q

Exam includes:

6) Vision: what may you see?

A 
Diplopia
Blurred vision
Optic neuritis
Scotoma (blind spot)
Nystagmus
19
Q

Exam includes:

7) skin integrity
8) Muscle tone, DTRs: what would you see?

A

Spasticity

Hyperreflexia

20
Q

Exam includes:

9) muscle strength/control: ______

A

Paresis

21
Q

Exam includes:

10) coordination: you may see what?
11) balance: ______ involvement

A

Ataxia
Intention tremor
Dysmetria
Dysdiadochokinesia

Vestibular

22
Q

Exam includes:

12) gait may be _________

A

Ataxia

23
Q

Exam includes:

_______ is the number one complaint as the day progresses

A

Fatigue

24
Q

What classes of drugs are used?

A

Immunosuppressant drugs
Interferon drugs
Sx management of spasticity
Sx management of urinary problems

25
Q

What are the immunosuppressant drugs that are used?

A

ACTH

Steroids (-sone)

26
Q

What are the interferon drugs that are used?

A

Avonex
Betaseron
Copaxone

27
Q

What spasticity drugs are used?

A

Baclofen, diazepam (Valium), dantrolene
Baclofen pump
Phenol block surgery

28
Q

What urinary drugs are used?

A

Anticholinergics

29
Q

What two things should you watch out for in your pts with MS?

A

UTI and respiratory infection

30
Q

What intervention can you use with diplopia?

A

Eye patching

31
Q

_______ ______ techniques are important for this population

A

Energy conservation

32
Q

Avoid precipitation exacerbations:
Use _________ practice schedule
Rest intervals should be carefully ___________
____ time > _____ time
Exercise should increase in _____ before _______

A

DISTRIBUTED
Spaced
Rest time > exercise time
Duration before intensity

KN JD NPTE: NM (27 decks)

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