Multiple Sclerosis

Front 1

MS is a disease affecting the _______

Back 1

-CNS

Front 2

MS is more common in men or women?

Back 2

-WOMEN

^^ sucks to be them

Front 3

T or F:
incidence of MS is correlated to location and latitude?

Back 3

TRUE

Incidence of MS and geographic latitude strongly correlated; the farther one travels from the earth's equator, the more cases of MS per capita. Great Britain, Scandinavia and Canada have 3 of the highest rates of MS in the world.

Front 4

The two ways to clinically diagnosis MS are dissemination in _______ and dissemination in ________.

Back 4

-TIME: occurrence of two or more distinct attacks.


-Space: Objective clinical evidence of two or more lesions in separate locations within the myelinated regions of the CNS

Front 5

How is optic neuritis described?

Back 5

"cellophane in eye"

-Optic Neuritis is one of the most common initial symptoms of MS and presents unilaterally in 70% of cases.

Front 6

Describe Uhthoffs phenomenon?

Back 6

increase or presence in neurological symptoms in response to a heating condition. Change in body temp that elicits signs ranges from .18ºF- 4.14ºF).

Front 7

T or F:
A majority of MS patients have heat intolerance?

Back 7

TRUE:
-80% of MS patients are sensitive to changes in core body temperature, from both external (environment) and internal (vigorous exercise) sources.

Front 8

What is described as their worst, or one of their worst symptoms?

Back 8

-FATIGUE

Front 9

LOOK AT PIC

Back 9

pic

Front 10

What type of MS do most patients start with?

Back 10

RRMS
-Relapsing-Remitting MS (RRMS)
80% of individuals with MS start as RRMS; women three times more likely to be diagnosed than men

Front 11

Describe RRMS briefly in general terms:

Back 11

Temporary symptom flare-ups or “exacerbations” (a.k.a. relapses, attacks, or bouts) typically last 1-3 months, followed by remissions (complete or partial recovery).

Front 12

Untreated RRMS may become ________?

Back 12

If untreated, >90% of individuals with RRMS may enter a second phase, called secondary progressive MS (SPMS) within 6-10 years. Characterized by progressive worsening of symptoms, with or without relapses.

Front 13

PICTURE FOR TYPES OF MS

Back 13

pic

Front 14

What are some symptoms that give a worse prognosis with MS?

Back 14

-Progressive (chronic) MS
-Onset after 40, especially males
-Significant pyramidal and cerebellar signs with involvement at multiple sites at 5 years after diagnosis.
-African American

Front 15

How are exacerbation of MS treated?

Back 15

Exacerbations treated with a high-dose, short-term course of corticosteroids (IV methylprednisolone, then oral prednisone).

Front 16

T or F:
High level evidence that exercise is effective in improving strength and endurance, self-efficacy, and quality of life in patients with MS

Back 16

TRUE

Front 17

___________ like symptoms are common with MS medication

Back 17

-Flu like

Front 18

Look over these for the Kurtzke Expanded Disability Status Scale

Back 18

-0.0: Normal Neurological Exam
-1.0: No disability, minimal signs on 1 FS
-1.5: No disability, minimal signs on 2 of 7 FS
-2.0: Minimal disability in 1 of 7 FS
-2.5: Minimal disability in 2 FS
-3.0: Moderate disability in 1 FS; or mild disability in 3 - 4 FS, though fully ambulatory
-3.5: Fully ambulatory but with moderate disability in 1 FS and mild disability in 1 or 2 FS; or moderate disability in 2 FS; or mild disability in 5 FS
-4.0: Fully ambulatory without aid, up and about 12hrs a day despite relatively severe disability. Able to walk without aid 500 meters
-4.5: Fully ambulatory without aid, up and about much of day, able to work a full day, may otherwise have some limitations of full activity or require minimal assistance. Relatively severe disability. Able to walk without aid 300 meters
-5.0: Ambulatory without aid for about 200 meters. Disability impairs full daily activities
-5.5: Ambulatory for 100 meters, disability precludes full daily activities
-6.0: Intermittent or unilateral constant assistance (cane, crutch or brace) required to walk 100 meters with or without resting
-6.5: Constant bilateral support (cane, crutch or braces) required to walk 20 meters without resting
-7.0: Unable to walk beyond 5 meters even with aid, essentially restricted to wheelchair, wheels self, transfers alone; active in wheelchair about 12 hours a -day
-7.5: Unable to take more than a few steps, restricted to wheelchair, may need aid to transfer; wheels self, but may require motorized chair for full day's activities
-8.0: Essentially restricted to bed, chair, or wheelchair, but may be out of bed much of day; retains self care functions, generally effective use of arms
-8.5: Essentially restricted to bed much of day, some effective use of arms, retains some self care functions
-9.0: Helpless bed patient, can communicate and eat
-9.5: Unable to communicate effectively or eat/swallow
-10.0: Death due to MS