Multiple Sclerosis || with error-free answers.
Multiple sclerosis correct answers • MS is a chronic, progressive, autoimmune disease of the
CNS
- T cells outside the CNS are activated and cross the blood brain barrier (bbb) to eventually
release a cascade of reactions
- antibodies signal attack on myelin, neural signal propagation efficiency is decreased =
neurological sxs
• CNS also includes CN 1&2, they are encapsulated within the dura
• MS is the most common cause of non-traumatic disability beginning in young adults
who gets MS? correct answers • 2-3x more common in females than males
• most are diagnosed between the ages of 20 and 40
• estimated 400,000 diagnosed in the U.S. and over 2 million worldwide
• more common in Caucasians of northern European ancestry than most other ethnicities
• appears to have genetic and environmental factors.
MS exacerbations correct answers • Multiple neurological symptoms occur in "attacks", relapses
or exacerbation
• Separate attacks are 30 or more days apart
• Symptoms must last 24 hrs and be unrelated to another dx
- no fever or flu
MS S&S correct answers • visual dysfunction
- usually the first sx
• fatigue
• weakness
• numbness
,• decreased balance
• decreased cognition
• bowel dysfunction
• bladder dysfunction
• pain
• spasticity
• depression
• amb dysfunction
• Uhthoff 's phenomenon
• sexual dysfunction
fatigue correct answers • The most common and most disabling symptom of those with MS
• 75% to 90% of pts
- >50% report fatigue as their worst problem.
• Primary fatigue may be the result of inflammation, demyelination or axonal loss
- direct result of disease process
- Sometimes described as an overwhelming "lassitude" and can often be aggravated by heat and
humidity
• secondary fatigue may result from sleep difficulties such as incontinence, depression, stress,
anxiety, spasms, pain or medications
- result of problems associated with exacerbation
Uhthoff's phenomenon correct answers • First described in 1824 but named after Wilhelm
Uhthoff in 1890
- Uhthoff noted increased neurological symptoms after a hot bath or exercise in those with MS.
• Hyperthermia creates a (usually) temporary worsening of clinical signs present in an estimated
60% to 80% of those with MS
- sxs only last 1-2 hours as long as pt cools off
, • The "bath tub test" was once used to help diagnose MS, before MRIs
• pt may not come to appointments on a hot day
ambulatory dysfunction correct answers • slow, cautious gait
• flexed hip and knees
• arms at low or high guard position
depression correct answers • 46% diagnosed with depression
- another 16.2% suggestive of undiagnosed depression
• Clinically significant depressive symptoms found in almost 42% (29% having moderate to
severe depression) of those with MS
• Of those with MS and major depressive disorder, 65.6% were without antidepressant meds
while another almost 5% were treated with sub-threshold dosage.
• Treatment has been found to improve adherence, cognitive disturbances, fatigue and quality of
life.
• activity also decreases depression so help them get moving
bladder dysfunction correct answers • Bladder dysfunction is found in up to 75%
• 44% reported urinary dysfunction.
• Bladder dysfunction affects 80-100% throughout the course of MS.
bowel dysfunction correct answers • Constipation affects 29-43% while fecal incontinence
affects 50%
• 34% spend greater than 30 minutes per day managing their bowel
- this can prevent people from going out, managing it is a big deal
sexual dysfunction correct answers • sexual dysfunction has a much larger detrimental impact on
the mental health aspects of HrQoL than severity of physical disability
• At least one sexual dysfunction could be found in 82.5 % of pts
Multiple sclerosis correct answers • MS is a chronic, progressive, autoimmune disease of the
CNS
- T cells outside the CNS are activated and cross the blood brain barrier (bbb) to eventually
release a cascade of reactions
- antibodies signal attack on myelin, neural signal propagation efficiency is decreased =
neurological sxs
• CNS also includes CN 1&2, they are encapsulated within the dura
• MS is the most common cause of non-traumatic disability beginning in young adults
who gets MS? correct answers • 2-3x more common in females than males
• most are diagnosed between the ages of 20 and 40
• estimated 400,000 diagnosed in the U.S. and over 2 million worldwide
• more common in Caucasians of northern European ancestry than most other ethnicities
• appears to have genetic and environmental factors.
MS exacerbations correct answers • Multiple neurological symptoms occur in "attacks", relapses
or exacerbation
• Separate attacks are 30 or more days apart
• Symptoms must last 24 hrs and be unrelated to another dx
- no fever or flu
MS S&S correct answers • visual dysfunction
- usually the first sx
• fatigue
• weakness
• numbness
,• decreased balance
• decreased cognition
• bowel dysfunction
• bladder dysfunction
• pain
• spasticity
• depression
• amb dysfunction
• Uhthoff 's phenomenon
• sexual dysfunction
fatigue correct answers • The most common and most disabling symptom of those with MS
• 75% to 90% of pts
- >50% report fatigue as their worst problem.
• Primary fatigue may be the result of inflammation, demyelination or axonal loss
- direct result of disease process
- Sometimes described as an overwhelming "lassitude" and can often be aggravated by heat and
humidity
• secondary fatigue may result from sleep difficulties such as incontinence, depression, stress,
anxiety, spasms, pain or medications
- result of problems associated with exacerbation
Uhthoff's phenomenon correct answers • First described in 1824 but named after Wilhelm
Uhthoff in 1890
- Uhthoff noted increased neurological symptoms after a hot bath or exercise in those with MS.
• Hyperthermia creates a (usually) temporary worsening of clinical signs present in an estimated
60% to 80% of those with MS
- sxs only last 1-2 hours as long as pt cools off
, • The "bath tub test" was once used to help diagnose MS, before MRIs
• pt may not come to appointments on a hot day
ambulatory dysfunction correct answers • slow, cautious gait
• flexed hip and knees
• arms at low or high guard position
depression correct answers • 46% diagnosed with depression
- another 16.2% suggestive of undiagnosed depression
• Clinically significant depressive symptoms found in almost 42% (29% having moderate to
severe depression) of those with MS
• Of those with MS and major depressive disorder, 65.6% were without antidepressant meds
while another almost 5% were treated with sub-threshold dosage.
• Treatment has been found to improve adherence, cognitive disturbances, fatigue and quality of
life.
• activity also decreases depression so help them get moving
bladder dysfunction correct answers • Bladder dysfunction is found in up to 75%
• 44% reported urinary dysfunction.
• Bladder dysfunction affects 80-100% throughout the course of MS.
bowel dysfunction correct answers • Constipation affects 29-43% while fecal incontinence
affects 50%
• 34% spend greater than 30 minutes per day managing their bowel
- this can prevent people from going out, managing it is a big deal
sexual dysfunction correct answers • sexual dysfunction has a much larger detrimental impact on
the mental health aspects of HrQoL than severity of physical disability
• At least one sexual dysfunction could be found in 82.5 % of pts
