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RNSG 1443 - Exam 3|Advanced Neurological Disorders Comprehensive Examination: Multiple Sclerosis, Myasthenia Gravis, Parkinson’s Disease, Huntington’s Disease, Amyotrophic Lateral Sclerosis, Guillain-Barré Syndrome, Trigeminal Neuralgia, Bell’s Palsy; Dem

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RNSG 1443 - Exam 3|Advanced Neurological Disorders Comprehensive Examination: Multiple Sclerosis, Myasthenia Gravis, Parkinson’s Disease, Huntington’s Disease, Amyotrophic Lateral Sclerosis, Guillain-Barré Syndrome, Trigeminal Neuralgia, Bell’s Palsy; Demyelination, Neurodegeneration, Autoimmune Pathophysiology, Axonal Damage, Glial Scarring, Cholinergic Dysfunction, Dopaminergic Deficiency, Basal Ganglia, Extrapyramidal Symptoms, Muscle Weakness, Spasticity, Tremor, Bradykinesia, Ataxia, Dysphagia, Paresthesia, Lhermitte’s Sign, Fatigue, Nystagmus, Dysarthria, Cognitive Changes, Respiratory Complications, Plasmapheresis, Immunomodulators, Corticosteroids, Anticholinesterase Therapy, Dopaminergic Therapy, Nursing Management, Assistive Devices, Safety, ADLs, Patient Education, Diagnostic Criteria, MRI, EMG, Genetic Testing Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Multiple Sclerosis (MS) disease of the central nervous system characterized by the demyelination (deterioration of the myelin sheath) of nerve fibers, with episodes of neurologic dysfunction (exacerbation) followed by recovery (remission). -Chronic Inflammation -Demyelination -Gliosis (scarring) of the nerves. Myelin is replaced with plaques. patho of MS - Initial attack - myelin damaged, but impulses able to transmit - myelin regenerate and replaced with scar tissue called plaques. - With repeat attacks, axon is permanently damaged. -usually begins with a clinically isolated acute neurologic syndrome greater than 24 hours -degeneration of CNS myelin sheath, scarring, loss of axons from autoantibodies and inflammatory response -t cells, B cells, macrophages, cytokines -hallmark plaque formation "glial scarring" -decreased nerve conduction -death of neurons & brain atrophy MS s/s Vision Changes (often 1st sign) Diplopia Coordination: •Ataxia •Dysphagia Fatigue (Highly predominant): Heat exacerbates (modafinil) Motor •Muscle Weakness •Spasticity (diazepam/baclofen) •Walking Speed (dalfampridine) Pain •Paresthesia (gabapentin) •Lhermitte's sign Bowel and Bladder •Spastic bladder (oxybutynin) •Flaccid bladder •Constipation Lhermitte's sign Patient seated or supine, patient actively/passively flexes head toward chest. Positive sign is sharp electric shock like sensation down the spine into the extremities indicating multiple sclerosis, myelopathy, or other demyelinating cord lesions

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RNSG 1443 - Exam 3|Advanced Neurological Disorders Comprehensive
Examination: Multiple Sclerosis, Myasthenia Gravis, Parkinson’s Disease,
Huntington’s Disease, Amyotrophic Lateral Sclerosis, Guillain-Barré
Syndrome, Trigeminal Neuralgia, Bell’s Palsy; Demyelination,
Neurodegeneration, Autoimmune Pathophysiology, Axonal Damage, Glial
Scarring, Cholinergic Dysfunction, Dopaminergic Deficiency, Basal Ganglia,
Extrapyramidal Symptoms, Muscle Weakness, Spasticity, Tremor,
Bradykinesia, Ataxia, Dysphagia, Paresthesia, Lhermitte’s Sign, Fatigue,
Nystagmus, Dysarthria, Cognitive Changes, Respiratory Complications,
Plasmapheresis, Immunomodulators, Corticosteroids, Anticholinesterase
Therapy, Dopaminergic Therapy, Nursing Management, Assistive Devices,
Safety, ADLs, Patient Education, Diagnostic Criteria, MRI, EMG, Genetic
Testing Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026



Multiple Sclerosis (MS)

disease of the central nervous system characterized by the demyelination (deterioration of the myelin
sheath) of nerve fibers, with episodes of neurologic dysfunction (exacerbation) followed by recovery
(remission).



-Chronic Inflammation



-Demyelination



-Gliosis (scarring) of the nerves. Myelin is replaced with plaques.




patho of MS

- Initial attack



- myelin damaged, but impulses able to transmit

,- myelin regenerate and replaced with scar tissue called plaques.



- With repeat attacks, axon is permanently damaged.



-usually begins with a clinically isolated acute neurologic syndrome greater than 24 hours



-degeneration of CNS myelin sheath, scarring, loss of axons from autoantibodies and inflammatory
response



-t cells, B cells, macrophages, cytokines



-hallmark plaque formation "glial scarring"



-decreased nerve conduction



-death of neurons & brain atrophy




MS s/s

Vision Changes (often 1st sign)



Diplopia



Coordination:



•Ataxia

, •Dysphagia



Fatigue (Highly predominant):



Heat exacerbates



(modafinil)



Motor



•Muscle Weakness



•Spasticity (diazepam/baclofen)



•Walking Speed (dalfampridine)



Pain



•Paresthesia (gabapentin)



•Lhermitte's sign



Bowel and Bladder



•Spastic bladder (oxybutynin)



•Flaccid bladder



•Constipation

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