Multiple Sclerosis Study Guide concept map PDF

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Summary

Concept Maps on each mentioned disease process for Exams in Advanced Adult Care Services...

Description

Multiple Sclerosis: chronic autoimmune disease that affects the myelin sheath and conduction pathway of the CNS - One of leading causes of neurologic disability of the brain and spinal cord - Characterized by period of remission and exacerbation (relapsing-remitted course) - Impulses still transmitted but not as effective - 4 types: o Relapsing-remitting (most common): symptoms develop and resolve in a few weeks to months, and patient returns to baseline.  During relapse phase they report loss of function + continuing symp. o Primary progressive: steady, gradual neurologic deterioration without remission of symptoms; no acute attacks o Secondary progressive: begins with relapsing-remitting that eventually becomes steadily progressive. o Progressive relapsing: frequent relapses with partial recovery but no return to baseline. Only seen in small percentage Assessment: can look like ALS - Obtain history: vision, mobility, sensory changes (early indicators) - Aggravating factors: fatigue, stress, overexertion, temperature extremes, or hot shower or bath - Is there a family history? - Key features: muscle weakness and spasticity, fatigue, intention tremors, dysmetria, paresthesia, hypoalgesia, ataxia, dysarthria, dysphagia, diplopia, nystagmus, scotomas, tinnitus, vertigo, + babinkski, absent abdominal reflexes, unsteady gait, GI and renal problems, mental status changes later - CT scan shows density in white matter and MS plaques later on Diagnostic: no specific test will show - Abnormal CSF, MRI shows plaques, Interventions: prevent exacerbations, manage symptoms, modify disease effect on Immune system - Drugs: immunomodulators or anti-inflammatories that can alter immunity o Interferon beta 1: modifies course of disease o Glatiramer acetate: similar to myelin based protein (SQ)  Avoid crowds + people with infection o Natalizumab: monoclonal antibody that binds to WBC to prevent further damage to myelin  IV infusion  High risk for PML  Damage to hepatic cells o Improve mobility with exercises and rehab...