weeks 5 and 6 Chronic/Patho Mobility & Oxygenation/ perfusion 1

Question 1

Multiple sclerosis what symptoms would be likely see

Answer 1

• balance issues/gait changes -weakness -fatique -pain -numbness -bowel and bladder issues -impaired communications - speech issues - eye changes (diplopia = double disions)
• swallowing issues

This is a demyelinating disease of the CNS

Question 2

Ataxia

Answer 2

poor coordination and unsteadiness

Question 3

Is daily exercise good for individuals with MS

Answer 3

yes, but with frequent rest periods so body temperature doesn’t raise which would worsen symptoms

stress can also worsen the symptoms

Question 4

Someone who has MS is typically on Interferon, what should we educate the client on while taking that drug

Answer 4

• wearing sunscreen
• rotation of IV site
• common side effects will mimic flu-like symptoms

Question 5

how much exercise should someone get with osteoporosis?

Answer 5

Regular weight bearing exercises 20- 30 min a day

weight training stimulates bone mineral density

Question 6

T/ F antiacids have calcium in them

Answer 6

true

Question 7

what would someone with osteoporosis take for pharm treatments?

Answer 7

• calcium and vitamin D
• Bisphosphonates
• Calcitonin
• Estrogen agonists/ .antagonists SERMS
• parathyroid hormone
• receptor activator of nuclear factor Kappa- B ligand inhibitor

Question 8

What should we not take with bisphosphonates?

Answer 8

calcium supplements or antacids that calcium are in them

Question 9

Estrogen promotes bone health T/F

Answer 9

True

Question 10

what are some medications that promote bone loss?

Answer 10

Corticosteroids, antiseizure, heparin, thyroid hormone

Question 11

Little Vitamin D can be a risk factor for what disease?

Answer 11

Multiable sclerosis and osteoporosis

MS also has high relevance with people in temperature extremes, woman, some infections such as epstein bar, diabetes mellitus type 1, thyroid disease and IBS, emotional trauma and pregnancy

Question 12

What is activated when someone has MS?

Answer 12

they will have HLA-DR2 which is present when the T-cells are activated

Too many T cells in people with MS causing Meylin breakdown

Question 13

What will we see on the white matter with MS?

Answer 13

hard sharp sclerotic plaques

Stage 1 is inflammation
Stage 2 is plaque formation (gliosis) and demyelination

Question 14

how is MS diagnosied?

Answer 14

Disease of exclusion

• requires 2 or more neurologic attacks
• MRI reveals MS plaque or scarring
• Evoked potential - reveal slow conduction of nerve impulses
• elvation of IgG and the presence of oligoclonal band in 90-95% of patients with MS (immune system abonrmality)

Question 15

Treatments of MS?

Answer 15

goal is to delay the progression.

reduce autoimmune response- interferon beta 1b

reduce spasity dantrolene

anticonvulsants for parathesias

speech and vision therapy
stretching and ROM
Adaptive equipment
PT

Question 16

There are 4 kinds of MS what is the most common

Answer 16

Relapsing-Remitting

clears relapses with stable between relapses

Question 17

what are the risk factors of osteoporosis?

Answer 17

White or Asian,
small bone structure,
low body weight,
post-menopausal (estrogen diffident) 
advanced age
family history
-high protein diet
-people on antacids because it interferes with calcium absorption

Question 18

what drugs and diseases are risk factors for Osteoporosis?

Answer 18

• Cushing disease
• celiac disease
• diabetes mellitus
• anorexia Nervosa
• hyper thyroid
• RA

Drugs; aluminum-containing antacids

• anticonvulsants
• heparin
• corticosteroids

Surgical: gastrectomy

Question 19

what do we do to measure bone density? what test?

Answer 19

DEXA scan

Question 20

what is the main difference between rheumatoid arthritis and osteoarthritis?

Answer 20

Rheumatoid has inflammation and Osteo does not.

osteoarthritis: has loss of hyaline cartilage of joints on articular surfaces, “early morning stiffness”

Rheumatoid arthritis: systematic autoimmune
Rheumatoid factor combines with IgG forming immune complex causing inflammation of synovial membranes
, Muscle atrophy decreased joint mobility

Question 21

What kinds of tests and treatments can be done for osteoarthritis?

Answer 21

Bone Scan

• CT
• MRI
• X-ray

Treatments: rest and joint protection
heat and cold application
-nutritional therapy and exercise
- joint replacement

Question 22

What kinds of tests and treatments can be done for Rheumatoid Arthritis?

Answer 22

• Rheumatoid factor
• Erythrocyte sedimentation rate (ESR)
• OTher inflammatory markers (CRP)
• Xrays

Treatment: PT
Occupational therapy
-joint replacement

Question 23

what can we find that is similar with RA and MS?

Answer 23

similarities of T cells and tumor necrosis factor (TNF) in both disease

Question 24

Basilar and vertebral stroke

Answer 24

cerebellum and brain stem

balance issues, vertigo, dysphagia, dysphonia, visual issues

Question 25

posterior cerebral sroke

Answer 25

occipital lobe so all of all eye issues, and color thalamus issues like cause sensory issues and spontaneous pain and tremors hemiparesis: one-sided paralysis

Question 26

Middle cerebral stroke?

Answer 26

most of the lateral hemisphere and deep structures of the fronter face and arm -contralateral hemiplegia altered consciousness, inability to turn eyes toward paralyzed sized

Question 27

anterior cerebral stroke?

Answer 27

the medial frontal lobe, paralysis of contralateral foot or leg problems making decisions, slowness, urinary incontinence

Question 28

asthma plan with peak flow meter at the same time every day twice a day for three weeks to understand personal best. what are the zones

Answer 28

15 min before physical activity Green zone peak flow meter shows 80% or above yellow zone peak flow meter 50-79% cough , wheezing and chest tightness and use a quick relief mediaton Red zone is anything under 50%

Question 29

What is the short-acting Bronchodilator?

Answer 29

Anticholinergics, Beta 2 (Albuterol)