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PAR3012 - Extended Care > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What is MS?

A

Disease of the Central Nervous System

It is an immune-mediated inflammatory disease

It disrupts the flow of information within the brain, and between the brain and body.

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2
Q

How does MS work?

A

The disease attacks myelinated axons in the central nervous system, destroying the myelin and the axon in variable degrees.

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3
Q

what are the causes of MS?

A

it likely involves a combination of genetic susceptibility

and a presumed non-genetic trigger (e.g. viral infection, low vitamin D levels)

Geographic variation in the incidence of MS supports the probability that environmental factors are involved in the aetiology

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4
Q

How can MS manifest?

A
  • Relapsing remitting
  • Primary progressive
  • Secondary progressive (when relapsing and remitting disease becomes progressive)
  • Progressive relapsing (a combination of relapsing remitting and progressive from the outset)
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5
Q

What are the s&s of MS?

A
  • Sensory loss
  • Spinal cord symptoms
  • Cerebullar symptoms
  • eye symptoms
  • trigeminal neuralgia
  • facial myokymia
  • constitutional symptoms
  • Pain
  • subjective cognitive difficulties
  • depression
  • euphoria
  • bipolar disorder or frank dementia
  • heat intolerance
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6
Q

what are some spinal cord symptoms of MS?

A
  • Muscle cramping secondary to spasticity (motor)

* Bladder, bowel, and sexual dysfunction (autonomic)

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7
Q

what are some cerebellar symptoms of MS?

A

Charcot’s Neuroligical Triad” of ataxic dysarthria (syllables), intention tremor (ataxia), and nystagmus (dancing eyes)

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8
Q

What are some eye symptoms of MS?

A

– 33% of patients
– Optic neuritis: Unilatpain & blur
– Diplopia (Vert II not =)
– Lateral gaze

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9
Q

What are some facial myokymi symptoms of MS?

A

– Irregular twitching of the facial muscles

– May also be a presenting symptom

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10
Q

How do you treat MS?

A
  • Corticosteroids:Methylprednisolone is the usual treatment given in acute attacks to reduce their severity
  • Beta-interferon:(Betaferon,Avonex,Rebif): This SCI drug can reduce the rate of relapses by a third. This is often the first-line treatment for relapsing/remitting disease.
  • Glatiramer acetate: (Copaxone): This drug is another immunomodifier that also reduces the frequency and severity of attacks.
  • Oral immunosuppressants: Recently developed and show promise in reducing the number of attacks.
  • Muscle relaxants: (baclofen, dantrolene, benzodiazepines): Can reduce the discomfort and pain of spasticity
  • Oxybutinin: a bladder muscle antispasmodic
  • Physiotherapy and Occupational Therapy: Important role
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11
Q

what is charcots neurological triad?

A
  • Ataxic dysarthia
  • intention tremor
  • nystagmus
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12
Q

what is motor neuron disease?

A

Motor neuron disorders (MNDs) are a group of neurologic diseases characterized by progressive degeneration of motor neurons.

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13
Q

What is the most common form of MND in adults?

A

Amyotrophic Lateral Sclerosis

aka

Lou Gehrig Disease.

• It is a fatal disorder and is characterized by progressive skeletal muscle weakness and wasting or atrophy (ie, amyotrophy), spasticity, and fasciculations as a result of degeneration of the Upper and lower Motor Neurons, culminating in respiratory paralysis.

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14
Q

What are the characteristics of MND?

A

MND is a progressive, terminal neurological disease

Sufferers progressively lose the ability to walk, talk, feed themselves, swallow, and ultimately breathe

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15
Q

What are the causes of MND?

A

Most cases of MND are sporadic:

•Occurring in scattered or isolated instances without clearly identifiable causes.
There are many theories about the causes of MND:

•Exposure to environmental toxins and chemicals, infection by viral agents, immune mediated damage, premature ageing of motor neurons, loss of growth factors required to maintain motor neuron survival and genetic susceptibility.

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16
Q

What are the S&S of MND?

A

symptoms begin with limb involvement. Initial complaints in patients with lower limb onset are often as follows:
• Tripping, stumbling, or awkwardness when running
• Foot drop; patients may report a “slapping” gait

Initial complaints with upper limb onset include the following:
• Reduced finger dexterity, cramping, stiffness, and weakness or wasting of intrinsic hand muscles
• Wrist drop interfering with work performance

17
Q

What are some emotional and special cognitive difficulties in some MND patients?

A
  • Involuntary laughing or crying
  • Depression
  • Impaired executive function
  • Maladaptive social behaviour
18
Q

What are some other symptoms of MND?

A
  • Distorted speech
  • Cramp
  • Muscle wasting
  • Swallowing difficulties
  • Shortness of breath
19
Q

What is parkinsons disease?

A

Parkinson’s disease (PD) is a type of movement disorder

Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years.

It is a progressive disease that can be slowed, but not halted, by treatment.
It happens when nerve cells in the brain don’t produce enough dopamine. Also the presences of Lewy bodies in the brain.

20
Q

what are the S&S of parkinsons

A 
 Tremor
Subtle decrease in dexterity
Decreased arm swing on the first-involved side
Soft voice
Decreased facial expression
Rapid eye movement Behaviour Disorder (RBD):
Symptoms of autonomic dysfunction
–Constipation
–Sweating abnormalities
–Sexual dysfunction
–Seborrheic dermatitis
A general feeling of weakness, malaise, or lassitude
Depression or anhedonia
Decreased sense of smell
Slowness in thinking
Sleep disturbances
21
Q

What are the motor symptoms of parkinsons?

A
  • Typically asymmetric
  • The most common initial finding is a resting tremor in an upper extremity
  • Over time, patients experience progressive bradykinesia, rigidity, and gait difficulty
  • Axial posture becomes progressively flexed and strides become shorter
  • Postural instability (balance impairment) is a late phenomenon
22
Q

What are three possible pathway solutions that can alleviate pressure on acture care?

A
  • Secondary phone triage (Refcom)
  • Paramedics Referring away from ED and transport to alternative providers
  • Extended care paramedics taking hospital care to the patient

PAR3012 - Extended Care (12 decks)

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