NP: Chapter 23 Multiple Sclerosis

Question 1

multiple sclerosis wat voor ziekte

Answer 1

chronic, of central nervous system -> multifocal inflammation and demyelination

Question 2

onset of ms

Answer 2

between 20-40 years

Question 3

prevalence of ms

Answer 3

most common neurological disorder in young adults

Question 4

ms also occurs in children

Answer 4

oke

Question 5

waar is de meeste inflammation

Answer 5

in white matter van: optic nerve, spinal cord, cerebellum and brain stem

Question 6

ms often starts with..

Answer 6

impairment of sensory perceptions in the limb, or temporary problems with vision

Question 7

what does inflammation of the brainstem cause

Answer 7

diplopia (dat je 2 beelden van ogen niet meer goed geintegreerd worden) en eye movement disorders

Question 8

what are other symptoms of ms

Answer 8

decreased strength, coordination of limbs, functional disorders, sexual dysfunction, spasticity, pain, fatigue.

Question 9

Unthoffs syndrome

Answer 9

MS patienten die meer last hebben van symptomen in hot climates

Question 10

met welke questionnaire meet je neurological limitations

Answer 10

expanded disability status scale EDSS

Question 11

edss model bekijken

Answer 11

oke

Question 12

relapse-remitting MS

Answer 12

periods of recurrence alternating with periods of remission in which the patient is free of symptoms.

Question 13

relapse =

Answer 13

inflammatory reaction in myelin sheet -> symptoms

Question 14

which is the most common subtype of ms

Answer 14

RRMS

Question 15

which subtypes of ms are there

Answer 15

relapse remitting ms
secondary progressive ms
primary progressive ms

Question 16

wanneer is RRMS een active disease

Answer 16

eerst niet, want de relapses occur once or twice per year on average. but recovery from these exerbations may be incomplete, which in turn may cause impairments

Question 17

secondary progressive ms

Answer 17

spms

after several years, 2/3 of rrms patients -> patterns of progressive deterioration with or without exacerbations and minimal remission.

Question 18

primary progressive ms

Answer 18

constant progression of symptoms from the onset of the disease

Question 19

hoeveel mensen hebben primary progressive ms

Answer 19

10-20% van de pt

Question 20

kijken naar figuur van ms subtypes

Answer 20

oke

Question 21

ms and life expectancy

Answer 21

life expectancy not severely affected by ms, most ppl die of other causes.

Question 22

what is needed for a diagnosis of MS

Answer 22

• at least two periods with clinical symptoms
• symptoms can be accounted for by various white matter lesions in CNS (dus ook 2 verschillende symptomen)

soms ook MRI scan voor lesions if MS is suspected

Question 23

wat voor csf differences hebben mensen met ms

Answer 23

increase lymphocytes and plasma cells, immunoglobulin g levels.

Question 24

evoked potential test

Answer 24

bij ms, performed to assess the conduction along bv de optic nerve pathway

Question 25

waar komt ms vaak voor

Answer 25

in temperate and cold zones

Question 26

ms gender

Answer 26

women more than men

Question 27

treatment of ms

Answer 27

high dose of corticosteroids -> kan maar even, voor temporary relief.
nu drugs die het nog meer terughouden, maar nog niks gevonden dat het echt cured.

Question 28

cause of ms

Answer 28

autoimmune, by exogenous trigger in ppl with specific genetic predispositions. maar exact cause is unknown

Question 29

hoeveel patienten met ms hebben cognitive impairments

Answer 29

40-70%

Question 30

paced auditory addition test

Answer 30

for information processing speed, ms performes slowly

Question 31

welk deel van memory is impaired bij ms

Answer 31

vooral retrieval, recognition is nog goed

Question 32

sterke relatie tussen severity of cognitive impairments and the severity of ms

Answer 32

oke

Question 33

what is the best predictor for cognitive functioning

Answer 33

cortical atrophy (not white matter lesions!)

Question 34

bv the width of the third ventricle is een goede voorspeller voor cognitive impairments

Answer 34

oke

Question 35

welke comorbidities bij ms

Answer 35

anxiety, bipolar and psychotic disorders
and depression a lot (30-50%)
15% of deaths bij ms are suicide

Question 36

wat is de most limiting symptom

Answer 36

fatigue