Chapter 23 MS

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  1. CNS progressive demyelinated disorder
  2. Is the peripheral nervous system involved in MS
  3. What gender is more affected by MS
  4. What is the normal age to be diagnoised with MS
  5. What race is primarily affected by MS
  6. What is the etiology of MS
  7. What have epidemiologist discovered
    viral illness in teens & genetic predisposition

    prevalent farther from equator

    uncommon in tropics

    not inherited,but family predisposition
  8. What cell produces myelin in the CNS
  9. What is the patho of MS
    nerve fibers in the white brain matter, spine, and optic nerves demyelinate

    lesions of plaque form
  10. How are the plaque lesions formed
    • immune-mediated inflammatory response
    • lymphs invade CNS
    • Killer T cells & Macs help damage oligodendrocytes
    • B cells migrate to CNS during inflammation
    • B Cells trapped after inflammation stops
    • proliferate into plasma cells
    • secreate IgG
    • IgG found in CSF
    • IgG composed of oligoclonal bands
  11. Is MS an autoimmune disorder
  12. What is not found in the serum
    indicates immunological acitivy in the brain
    and is useful in the diagnosis of MS
    CSF oligoclonal IgG
  13. What happens to CNS with each exacerbation of MS
    • more areas of the CNS are involved
    • eventually degenertaion becomes irreversable
  14. What are the signs of MS
    • optic neuritis
    • diplopia
    • blurred vision
    • scotoma
    • nystagmus
    • parathesias
    • fatigue
    • muscular weakness
    • unsteady gait
    • hyperreflexia
    • paraplegia/quadraplegia
    • sphincter abnormalities
    • dysphagia
    • speech problems
    • dysarthria
    • heat intolerance
    • emotional disturbances
  15. What is optic neuritis
    unilateral visual impairment from clouding, blurry, or complete vision loss
  16. What is diplopia
    double vision
  17. What is a scotoma
    a spot in the vision field
  18. involuntary movement of the eye in all directions
  19. loss of the sensation of touch accompanied by tingling or burning to the face and extremities
  20. What is the rationale behind muscle weakness in MS
    related to the plauqes forming on the corticospinal tract
  21. What causes paraplegia or quadriplegia in MS
    plauqes and edema blocking transmission to the spinal cord
  22. Why would speech problems occur in a patient with MS
    impairment of tounge or other speech muscles
  23. What is dysarthria
    poor articulation
  24. What effect can heat have on individuals with MS
    worsen signs and symptoms
  25. What is the rationale behind the emotional outbursts associated with MS
    plauqes on the temporal and frontal lobes
  26. What are the diagnostic test used for MS
    • H&P
    • MRI
    • CT
    • CSF
    • Evoked response studies
  27. What is the CSF examined for when checking for MS
    elevated oligoclonal IgG
  28. What are evoked respopnse studies
    electrophysiologically showing delays to stimuli in unmylienated axons
  29. What are the complications of MS
    • progressive and chronic disability
    • paralysis
    • respiratory infection
    • cystitis/kidney infection
    • death
  30. Why is repiratory infection a possible complication of MS
    impaired ventilation
  31. Why would a person with MS get cystitis
    • urinary incontinence leads to urinary stasis
    • causing an infection
  32. What will normally cause the death of a patient with MS
  33. What are the treatments for a patient with MS
    • Pallative
    • steroids
    • interferon
    • physical therapy
    • healthy outlook
  34. Why are steroids given to a patient with MS
    • mainstay for acute relapse
    • reduce inflammation
    • improve nerve condition
    • reduce exabcerbations
  35. What is always a concern when prescribing corticosteroids to a patient
    side effects
  36. How does interferon treatment work in MS
    • cytokine prevents viral replication
    • decreases antibody formation
    • antibodies not there to attack mylein sheath
  37. Why is physical therapy done for patients with MS
    maintain mucscle tone
  38. What is the prognosis for MS
  39. Which MS patients have a worse prognosis
    onset after 40 or early motor disability development early in the course of the disease
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Chapter 23 MS
Chapter 23 MS
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