Defensor Multiple sclerosis

Question 1

Autoimmune nervous system disorders include

Answer 1

multiple sclerosis

myasthenia gravis

Guillan-Barre syndrome

Question 2

is an immune-mediated, progressive demyelinating disease of the CNS

Answer 2

multiple sclerosis

Question 3

refers to the destruction of myelin

Answer 3

demyelination

Question 4

the fatty and protein material that surrounds certain nerve fibers in the brain and spinal cord

Answer 4

myelin

Question 5

MS may occur at any age, but the age peak of onset is between ___ and ___ years

Answer 5

20 and 50 years

Question 6

the cause of MS is

Answer 6

unknown

Question 7

MS is considered to have many risks, including

Answer 7

genetic factors

Question 8

MS is believed that

Answer 8

DNA on the virus mimics the amino acid sequence of myelin

Question 9

environmental risks of MS include

Answer 9

obesity

lack of vitamin D exposure

high salt diet in teenage years

Question 10

there are several acute and subacute forms of MS less severe forms include

Answer 10

radiologically isolated syndrome (RIS)

Clinically isolated syndrome (CIS)

Question 11

____ consists of MS like lesions that are identified on MRI in the absence of clinical signs and symptoms

Answer 11

Radiologically isolated syndrome

Question 12

___ is the presence of acute or subacute clinical findings for at least 24 hours

Answer 12

Clinically isolated syndrome

Question 13

The four main clincal forms are

Answer 13

remitting-relapsing

secondary progressive

primary progressive

progressive relapsing

Question 14

sensitized __ and ___ lymphocytes cross the blood-brain barrier

Answer 14

T and B

Question 15

function of T and B lymphocytes

Answer 15

to check the CNS for antigens and then leave

Question 16

____ remain in the CNS and promote the infiltration of other agents that damage the immune system

Answer 16

sensitized T cells

Question 17

the areas most frequently affected are the

Answer 17

optic nerves, chiasm, and tracts

the cerebrum

the brainstem and cerebellum

spinal cord

Question 18

the patient with ___ will have no symptoms

Answer 18

RIS

Question 19

typical presentation of CIs includes

Answer 19

unilateral optic neuritis

focal symptoms

partial myelopathy

Question 20

approx 85% of patient have ___ with each relapse, recovery is usually complete: however residual deficits may occur and accumulate overtime

Answer 20

Relapsing-Remitting Multiple Sclerosis (RRMS)

Question 21

approx 15% of patients have ____, in which disabling symptoms steadily increase with rare plateaus and temporary minor improvement

Answer 21

Primary Progressive Multiple Sclerosis (PPMS)

Question 22

Primary Progressive Multiple Sclerosis (PPMS) may result in

Answer 22

quadriparesis

cognitive dysfunction

visual loss

brainstem syndromes

Question 23

the least common presentation is ____ which is characterized by relapses with continuous disabling progression between exacerbations

Answer 23

progressive-relapsing

Question 24

common s/sx of MS

Answer 24

fatigue

depression

weakness

Question 25

visual distubances due to lesions in the optic nerves or their connections may include

Answer 25

blurring of vision diplopia scotoma total blindness

Question 26

double vision, or the awareness of two images of the same object occurring in one or both eyes

Answer 26

diplopia

Question 27

patchy blindness

Answer 27

scotoma

Question 28

_____ affects most people with MS and is often the most disabling symptom

Answer 28

fatigue

Question 29

may contribute to fatigue

Answer 29

heat depression anemia

Question 30

additional sensory manifestation include

Answer 30

paresthesias dysesthesias proprioception losses

Question 31

MS need daily analgesic medications in some cases pain is managed with

Answer 31

opioids anticonvulsant medications antidepressants medications

Question 32

among women who are perimenopausal, those with MS are more likely to have pain related to

Answer 32

osteoporosis

Question 33

play a role in the development of osteoporosis among women

Answer 33

estrogen loss immobility corticosteroid therapy

Question 34

is characterized by muscle hypertonicity with increased resistance to stretch

Answer 34

spasticity

Question 35

spasticity is associated with

Answer 35

weakness increased deep tendon reflex diminished superficial reflex

Question 36

cognitive and psychosocial problems may reflect

Answer 36

frontal or parietal lobe involvement

Question 37

some degree of cognitive change eg:

Answer 37

memory loss decreased concentration

Question 38

involvment of the ____ or ____ can produce ___ and _____

Answer 38

cerebellum or basal ganglia ataxia and tremors

Question 39

an important component is the presence of plaques in the CNS disseminated in space and over time observed on ___ with no better explanation

Answer 39

MRI scans

Question 40

THERE IS NO CURE FOR MS

Answer 40

NO CURE REMINDER

Question 41

an individual treatment program is indicated to

Answer 41

relieve symptoms and provide continuing support

Question 42

the goals of treatment are to

Answer 42

delay the progression of the disease, manage chronic symptoms and treat exacerbations

Question 43

common symptoms requiring intervention include

Answer 43

ataxia fatigue spasticity

Question 44

____ delay disease progression in many forms of MS

Answer 44

disease-modifying therapies

Question 45

the key concept of disease-modifying therapies is to reduce the

Answer 45

frequency of relapse duration of relapse number and size of plaques

Question 46

are administered subcutaneously every other day

Answer 46

interferon beta-1a

Question 47

side effects of all interferon-beta medications include

Answer 47

flulike symptoms headache depression

Question 48

also reduces the rate of relapse in RRMS and is administered subcutaneously daily

Answer 48

Glatiramer acetate

Question 49

are oral disease-modifying therapies that may be better tolerated by the patient who has difficulty with injection reactions

Answer 49

teriflunomide fingolimod dimethyl fumarate

Question 50

used to treat acute exacerbation, shortens duration of relapse but has not been found to have long term benefit

Answer 50

IV methylprednisolone

Question 51

IV methylprednisolone mechanism of action

Answer 51

exerts anti inflammatory effects by acting on T cells and cytokines

Question 52

IV methylprednisolone administration

Answer 52

given 1g IV daily for 3-5 days followed by an oral taper of prednisone

Question 53

IV methylprednisolone side effects

Answer 53

mood swings weight gain electrolyte imbalance

Question 54

____ is given via IV infusion every 3 months. ____ can reduce the frequency of clinical relapse in pt's with secondary progressive or worsening RRMS

Answer 54

mitoxantrone

Question 55

medications under disease modifying therapies

Answer 55

Interferon beta-1a glatiramer acetate mitoxantrone

Question 56

____ a gamma-aminobutyric acid agonist, is the medication of choice for treating spasticity

Answer 56

Baclofen

Question 57

how to give baclofen

Answer 57

can be given orally or by intrathecal injection for severe spasticity

Question 58

may also be used to treat spasticity and improve motor function

Answer 58

Benzodiazepines tizanidine dantrolene

Question 59

fatigue that interferes with ADL may be treated with

Answer 59

amantadine pemoline dalfampridine

Question 60

____ is a chronic problem most resistant to treatment

Answer 60

ataxia

Question 61

medications used to treat ataxia include

Answer 61

Benzodiazepines beta-adrenergic blockers anticonvulsant agent gabapentin

Question 62

bladder and bowel problems are often difficult for patients and a variety of medications ________ may be prescribed

Answer 62

anticholinergic agents alpha adrenergic blockers antispasmodic agents

Question 63

may be superimposed on the underlying neurologic dysfunction

Answer 63

UTI

Question 64

the major goals for the patient may include

Answer 64

promotion of physical mobility avoidance of falls decreasing fatigue

Question 65

Nursing interventions for MS

Answer 65

preventing falls promoting physical mobility managing fatigue