Adult Exam 2 – Questions With Appropriate
Solutions
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Terms in this set (140)
ALS late-onset fatal neurodegenerative disease of UMN
and LMN; found more often in men than women
avg age of onset- 58 y.o. but has been Dx as early
as 20 y.o.
voluntary muscle control is affected, early
manifestations indicating UMN or LMN disease vary
with the site of initial disease process
ALS UMN involvement results in weakness, spasticity, hyperreflexia
typically eye mvmt, bowel/bladder control, and
sensation not affected
,ALS LMN involvement results in weakness/muscle atrophy of extremities,
cervical extensor weakness, fasciculations, muscle
cramps, loss of reflexes
typically eye mvmt, bowel/bladder control, and
sensation not affected
etiology of ALS o 6,000 people in USA are Dx annually (15
people/day)
o Approx. 20,000 Americans have this at any given
time
o 60% of people are male
o 93% of people are white
o Military veterans, particularly those deployed
during the golf war, are 2x as likely to develop this
Dx of ALS o No special test is available to est. the Dx, and
cause is unknown
o Initial symptoms vary widely, and Dx is a careful,
multistep system of exclusion
o A comprehensive Dx workup includes, most, if not
all, of the following procedures:
Electrodiagnostic tests including EMG and nerve
conduction velocity (NCV)
Blood and urine studies including high resolution
serum protein electrophoresis, thyroid, and
parathyroid hormone levels and 24 hr urine
collection for heavy metals
Spinal tap
X-rays, including MRI
Myelogram of cervical spine
Mm and/or nerve biopsy
Thorough neurological exam
types of ALS o Sporadic- most common in US
90-95% of all cases
o Familia- small number of cases in US
5-10% of all cases
o Guamaniam
High incidence was observed in the 50's
,Mean survival of individuals with ALS 3-5 y. many lives 5, 10, or more years
Stage I of ALS ambulatory, no problems with ADL, mild weakness
stage II of ALS ambulatory, moderate weakness in certain muscles
Stage III of ALS ambulatory, severe weakness in certain muscles
Stage IV of ALS w/c confined, almost independent, severe weakness
in legs
Stage V of ALS w/c confined, dependent; pronounced weakness in
legs, severe weakness in arms
Stage VI of ALS bedridden, no ADL, max A required
Assessments specific to ALS ALS functional rating scale
Purdue pegboard or other timed UE function test
and standard ROM and MMT
Multidimensional fatigue inventory
goal setting for early stages of ALS Optimize strength and ROM using home exercise
programs
Maintain function in ADL/IADL through use of AT,
home modification
Decrease pain and fatigue through use of
splints/orthotics
Employ joint protection, pain management, energy
conservation, and work simplification techniques
, goal setting for later stages of ALS Focus on enabling the CG to assist pt safely and
effectively
Optimize safety, assess positioning, perform safe
transfers, and maintain skin integrity
Employ augmentative communication equipment
Assess and manage dysphagia
Optimize social participation
Identify and obtain equipment to allow cont.
mobility
Environmental mod
Tx options for ALS o OTs must be aware of client's level of tolerance for
gadgets, financial resources, and social/cultural
context
o Special Tx considerations:
Exercise
Equipment
AT
Dysphagia management
Guillain-Barre Syndrome (GBS) o Aka acute inflammatory demyelinating
polyneuropathy
o Autoimmune disorder
o Results in acute neuromuscular failure
o Body's immune system attacks myelin sheath
covering the nerve, resulting in a slower signal
transmission through nerve
Etiology of GBS o Exact etiology unknown
o Distribution is worldwide
o 1.3-2 per 100,000
o 1.5 x more likely in men
o Ages: 20-24 and 70-74
o No hereditary susceptibility or vaccinations cause
this
o Enteritis precedes this in 41% of cases
Some respiratory infections, HIV/AIDS
Solutions
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Match Blocks Charms NEW
Terms in this set (140)
ALS late-onset fatal neurodegenerative disease of UMN
and LMN; found more often in men than women
avg age of onset- 58 y.o. but has been Dx as early
as 20 y.o.
voluntary muscle control is affected, early
manifestations indicating UMN or LMN disease vary
with the site of initial disease process
ALS UMN involvement results in weakness, spasticity, hyperreflexia
typically eye mvmt, bowel/bladder control, and
sensation not affected
,ALS LMN involvement results in weakness/muscle atrophy of extremities,
cervical extensor weakness, fasciculations, muscle
cramps, loss of reflexes
typically eye mvmt, bowel/bladder control, and
sensation not affected
etiology of ALS o 6,000 people in USA are Dx annually (15
people/day)
o Approx. 20,000 Americans have this at any given
time
o 60% of people are male
o 93% of people are white
o Military veterans, particularly those deployed
during the golf war, are 2x as likely to develop this
Dx of ALS o No special test is available to est. the Dx, and
cause is unknown
o Initial symptoms vary widely, and Dx is a careful,
multistep system of exclusion
o A comprehensive Dx workup includes, most, if not
all, of the following procedures:
Electrodiagnostic tests including EMG and nerve
conduction velocity (NCV)
Blood and urine studies including high resolution
serum protein electrophoresis, thyroid, and
parathyroid hormone levels and 24 hr urine
collection for heavy metals
Spinal tap
X-rays, including MRI
Myelogram of cervical spine
Mm and/or nerve biopsy
Thorough neurological exam
types of ALS o Sporadic- most common in US
90-95% of all cases
o Familia- small number of cases in US
5-10% of all cases
o Guamaniam
High incidence was observed in the 50's
,Mean survival of individuals with ALS 3-5 y. many lives 5, 10, or more years
Stage I of ALS ambulatory, no problems with ADL, mild weakness
stage II of ALS ambulatory, moderate weakness in certain muscles
Stage III of ALS ambulatory, severe weakness in certain muscles
Stage IV of ALS w/c confined, almost independent, severe weakness
in legs
Stage V of ALS w/c confined, dependent; pronounced weakness in
legs, severe weakness in arms
Stage VI of ALS bedridden, no ADL, max A required
Assessments specific to ALS ALS functional rating scale
Purdue pegboard or other timed UE function test
and standard ROM and MMT
Multidimensional fatigue inventory
goal setting for early stages of ALS Optimize strength and ROM using home exercise
programs
Maintain function in ADL/IADL through use of AT,
home modification
Decrease pain and fatigue through use of
splints/orthotics
Employ joint protection, pain management, energy
conservation, and work simplification techniques
, goal setting for later stages of ALS Focus on enabling the CG to assist pt safely and
effectively
Optimize safety, assess positioning, perform safe
transfers, and maintain skin integrity
Employ augmentative communication equipment
Assess and manage dysphagia
Optimize social participation
Identify and obtain equipment to allow cont.
mobility
Environmental mod
Tx options for ALS o OTs must be aware of client's level of tolerance for
gadgets, financial resources, and social/cultural
context
o Special Tx considerations:
Exercise
Equipment
AT
Dysphagia management
Guillain-Barre Syndrome (GBS) o Aka acute inflammatory demyelinating
polyneuropathy
o Autoimmune disorder
o Results in acute neuromuscular failure
o Body's immune system attacks myelin sheath
covering the nerve, resulting in a slower signal
transmission through nerve
Etiology of GBS o Exact etiology unknown
o Distribution is worldwide
o 1.3-2 per 100,000
o 1.5 x more likely in men
o Ages: 20-24 and 70-74
o No hereditary susceptibility or vaccinations cause
this
o Enteritis precedes this in 41% of cases
Some respiratory infections, HIV/AIDS
