Week 5 - MS

Question 1

What pathologies cause MS?

Answer 1

Inflammatory and Neurogenerative

Question 2

MS is a complex _____-____ based progressive _________ ______.

Answer 2

Auto-immune

Neurological disorder

Question 3

What kind of white blood cells help immune functioning?

Answer 3

B cells

T cells

Question 4

What are B cells?

Answer 4

White blood cells that help immune function

• develop in bone marrow
• produce antibodies that ambush foreign antigens in bloodstream

Question 5

What are T cells?

Answer 5

White blood cells that help immune function

• Develop in thymus gland (near lungs)
• direct attacks of foreign substances such as bacteria, viruses or foreign tissues (cancerous cells)
• Augment B cell response
• Produce substances called cytokines that direct responses and activities in other immune cells

Question 6

Where do T cells develop?

Answer 6

Thymus gland (near lungs)

Question 7

What are the visual symptoms of MS?

Answer 7

Nystagmus
Optic neuritis
Diplopia

Question 8

What are some central symptoms of MS?

Answer 8

Fatigue

Cognitive impairment

Depression

Unstable mood

Question 9

What are some symptoms of speech/throat associated with MS?

Answer 9

Dysarthria

Question 10

What are some musculoskeletal symptoms of MS?

Answer 10

Weakness

Spasms

Ataxia

Question 11

What are some sensation symptoms of MS?

Answer 11

Pain

Hypothesias

Paraethesias

Question 12

What are some bowel symptoms of MS?

Answer 12

Incontinence

Diarrhea or constipation

Question 13

What are some urinary symptoms of MS?

Answer 13

Incontinence

Frequency or retention

Question 14

What is the age of onset for MS?

Answer 14

Late 20s/early 30s

Question 15

What gender is more prone to MS?

Answer 15

Females

Question 16

How many people worldwide have MS?

Answer 16

2.5mil

Question 17

How many people in Australia currently have MS?

Answer 17

24,000

Question 18

What are the 4 types of MS?

Answer 18

Relapsing-remitting

Primary progressive

Secondary progressive

Progressive-relapsing

Question 19

What is relapsing-remitting MS?

Answer 19

Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission

Question 20

What is primary progressive MS?

Answer 20

Steady increase in disability without attacks

Question 21

What is secondary progressive MS?

Answer 21

Initial relapsing-remitting MS that suddenly begins to have decline without periods of remission

Question 22

What is progressive-relapsing MS?

Answer 22

Steady decline since onset with superimposed attacks

Question 23

What is often considered an ‘invisible symptom’ of MS?

Answer 23

Cognitive impairment

Question 24

How many people with MS in Australia have cognitive impairments?

Answer 24

58%

Question 25

What cognitive areas are most affected by MS?

Answer 25

Processing speed Complex attention New learning and memory Prospective memory Executive functions Social cognition

Question 26

What cognitive areas are least affected by MS?

Answer 26

General knowledge Intelligence Basic attention and orientation Language Immediate recognition memory Implicit memory

Question 27

why is a lack processing speed a hallmark feature of MS?

Answer 27

Myelin loss Slowed neuron/nerve conduction Invisible damage to neurons/nerves

Question 28

What is affected by slow processing speed?

Answer 28

Higher-order cognition (eg. executive functioning, memory)

Question 29

What tests may be used to assess processing speed?

Answer 29

Symbol digit Modality test

Question 30

How is complex attention affected by MS?

Answer 30

Working memory Divided attention (eg. switching between tasks, do one task and forget about the other) Sustained attention

Question 31

How does MS affect long-term memory?

Answer 31

One of the most reported symptoms Forgetting what someone tells you Having a thought but then forgetting it quickly Learning difficulties rather than retrieval prospective memory

Question 32

What undermines a persons memory with MS?

Answer 32

Slow processing speed Susceptibility to interference Executive difficulties visual difficulties

Question 33

How does MS affect visualspatial abilities?

Answer 33

Visual disturbances due to optic nerves (optic neuritis) Can result in difficulties with: Organising visual info seeing relationships between objects Proprioception

Question 34

How does MS affect executive abilities?

Answer 34

Disorganisation Difficulty sequencing/planning Problem solving difficulties Lack flexibility Lack ability to maintain focus with distractors

Question 35

What undermines executive function for people with MS?

Answer 35

Slow processing speed

Question 36

How does the pseudobular affect, affect social cognitions?

Answer 36

Uncontrollable laughing/crying More intense/ out of context

Question 37

How does MS affect social cognitions such as emotion recognition?

Answer 37

Impaired on fear and anger

Question 38

How can we measure a person's theory of mind?

Answer 38

Mind in the Eyes Task TASIT - measures sarcasm

Question 39

What social cognitions are affected by MS?

Answer 39

Pseudobular affect Emotion recognition Theory of mind Emotional lability Inappropriate behaviour eg. sexual disinhibition

Question 40

How is MS dementia different from AD?

Answer 40

Basic language intact in MS relative to AD Complex attention impaired more than AD in early phases Memory problems different in MS - due to retrieval or initial acquisition in MS rather than storage/retention in AD Orientation to place/person rarely affected in MS

Question 41

What are some treatments for MS relapses?

Answer 41

Corticosteroids Plasma exchange

Question 42

What are the three types of disease modifying therapies or DMTs?

Answer 42

Immunosuppressants Immunomodulators Immune constitution therapy

Question 43

What are the six stages of stem cell therapy?

Answer 43

1. Stem cells moved from bone marrow to blood stream using chemotherapy and synthetic growth factor 2. Machine collects blood and separates out stem cells 3. Stem cells frozen ready to return to body later 4. More chemotherapy used to fully or partially wipe out bone marrow and immune system 5. Stem cells returned tp body using a drip 6. Body recovers over a period of 3-6 months or longer

Question 44

How may you improve memory in people living with MS?

Answer 44

Use techniques to increase chances of encoding/storing information

Question 45

How may you improve executive abilities in those with MS?

Answer 45

Break things down into manageable steps Take time to plan ahead and diarise For big decisions, take time to list alternatives Ask for help with more difficult tasks

Question 46

How can you lower fatigue symptoms of MS?

Answer 46

Take regular breaks Do important tasks when most alert CBT - change perceptions of management

Question 47

How can sleep quality improve cognition?

Answer 47

Better sleep = better memory and executive functioning

Question 48

How can exercise improve cognition?

Answer 48

Improves verbal memory Increases cardio-respiratory fitness Lowers inhibitory errors