multiple sclerosis (ms)

Question 1

MS

Answer 1

-autoimmune, chronic, degenerative disease of the CNS
-the immune system damages or de-myelinates the protective sheaths covering nerves, the sheaths become inflamed & nerves cannot properly send messages around the body

Question 2

pts w MS have periods of

Answer 2

intermittent disease & relapses, coupled w periods of disability & recovery

Question 3

risk factors

Answer 3

-autoimmune diseases
-decreased vit d
-smoking
-obesity
-some viruses/bact. such as epstein barr

Question 4

there are 4 phases

Answer 4

-relapsing-remitting
-primary progressive
-secondary progressive
-progressive-relapsing

Question 5

can be diagnosed as young as __ & as old as __

Answer 5

10 & 60-70

Question 6

causes

Answer 6

-genetic or auto-immune; presence of genes that code for HLA genes
-viral; increased clusters at certain latitudes, cases with families, geographical clusters
-combined; autoimmune combinded w environmental or viral exposure in early life

Question 7

__% of pts live active, prolonged lives w prolonged remissions

Answer 7

70%

Question 8

avg duration can exceed

Answer 8

25 yrs

Question 9

subjective s/s

Answer 9

-fatigue
-limb weakness
-parasthesias
-double vision
-slurred speech
-imbalance
-incontinence
-depression
-temp liability
-impotence in men

Question 10

objective s/s

Answer 10

-dysarthria
-babinski sign
-clonus
-hand paralysis
-hemiparesis
-hyperactive deep tendon reflexes
-loss of position & vibration sense
-ataxia

Question 11

diag studies

Answer 11

-mri will show demyelinating plaques
-lumbar puncture; csf will show increase in igG
-evoked potential studies

Question 12

acute phase medical management

Answer 12

-methylprednisone
-methotrexate

Question 13

spasticity symptom management

Answer 13

-dantrium
-valium
-zanaflex

Question 14

fatigue symptom management

Answer 14

-symmetrel
-adderall

Question 15

depression symptom management

Answer 15

-sentraline
-fluoxetine
-fluvoxamine

Question 16

bladder dysfunction symptom management

Answer 16

-ditropan
-pro-banthine

Question 17

ataxia tremors symptom management

Answer 17

-klonopin
-tegretol

Question 18

pain symptom management

Answer 18

-elavil
-saids

Question 19

tx & disease management

Answer 19

-assure referrals to specialists are made; urology, physical therapy, neurology, behavioral health
-advanced stages; teach self catheterization, infection prevention

Question 20

complementary & alternative practices

Answer 20

-vit d
-exercise
-acupuncture
-cooling strategies

Question 21

managing exacerbations

Answer 21

-may need corticosteroids for severe relapse to quickly resolve symptoms; loss of vision, severe weakness, poor balance
-rehab, pt, ot, & slp can assist in resolving symptoms of relapse, address mobility issues, & adls, & restore or maintain physical functioning

Question 22

ms management includes

Answer 22

-modifying disease course
-treating relapses/exacerbations/attacks
-managing s/s
-ongoing rehab for functional mobility, safety, independenc, home & work life, involvement in the community
-assess safety issues in the home related to spacsticity

Question 23

for urinary retention related to sensorimotor deficits

Answer 23

-bladder training
-self-catheterization (prefferred)
-use of crede maneuver; manual pressure on the abdomen at the location of the bladder, not for long term