Quiz 19: Multiple Sclerosis

Based on knowledge of the epidemiology of multiple sclerosis (MS),which of the following patients is most likely to develop MS? A)A 65-year-old white man B)A 38-year-old African-American woman C)A 30-year-old white woman D)A 54-year-old African-American man

Which of the following is true with regard to geographic distribution and MS? A)The highest frequency of MS occurs in areas of the southern United States and Europe and Northern Australia. B)The highest frequency of MS occurs in areas of the northern United States and Europe,Scandinavian countries and southern Australia. C)The highest frequency of MS occurs in tropical areas of Asia,Africa,and South America. D)Geographical location does not affect frequency of MS.

MS is thought to be A)an X-linked recessive disorder. B)an autoimmune disease induced by an infectious agent. C)degeneration of the anterior horn cells due to an environmental toxin. D)a slow progressive disorder of the basal ganglia.

Which of the following statements is not true with regard to the pathophysiology of MS? A)MS is characterized by active demyelination that slows or blocks neural transmission. B)In the early stages oligodendrocytes survive and are able to produce remyelination. C)Demyelinated areas undergo a process of gliosis that results in plaque formation. D)Remyelination allows for improvement of function during remissions.

The most common form of MS is A)benign MS. B)primary progressive MS. C)malignant MS. D)relapsing-remitting MS.

Which of the following environmental conditions can result in a pseudoexacerbation in patients with MS? A)Cold temperatures B)Hot temperatures C)High altitude D)High humidity

Your patient's chart indicates he has a scotoma.This refers to A)a loss of peripheral vision. B)blurred vision that occurs with fatigue. C)a dark spot that appears in the center of the visual field. D)a loss of the pupillary light reflex.

Which of the following are common symptoms in patients with MS? A)Hypotonia,weakness,paresthesia,fatigue B)Fatigue,bradycardia,spasticity,weakness C)Weakness,resting tremors,hypotonia,visual disturbances D)Visual disturbances,urinary dysfunction,spasticity,pain

Which of the following is true with regard to fatigue and MS? A)Fatigue is a relatively rare symptom in patients with MS. B)Fatigue is directly related to severity of disease. C)Fatigue comes on abruptly and resembles an overwhelming flu-like exhaustion. D)Most patients report only mild fatigue that occurs primarily after exercise.

Which of the following statements is true with regard to life expectancy in patients with MS? A)Prognosis is fairly good; for most patients life expectancy is not reduced. B)Prognosis is poor; the majority of patients with MS will die within 5 years of symptom onset. C)Life expectancy is significantly related to whether or not patients are taking disease-modifying agents. D)Men diagnosed with MS tend to live only 5 to 7 years,while women live an average of 10 years after diagnosis.

Which of the following statements is true with regard to the prognosis of patients with MS? A)Onset with only one symptom is associated with a favorable prognosis. B)Older age (after 45)is associated with a more favorable prognosis. C)The strongest indicator of a favorable prognosis is a positive attitude. D)Patients with primary progressive MS have the best prognosis.

Which of the following is true with regard to disease-modifying drugs (such as Betaseron,Avonex,and Copaxone)and their use in patients with MS? A)They are indicated for patients with both progressive and relapsing remitting forms of MS. B)They result in a reversal of existing symptoms in 30% to 50% of patients. C)In some patients,they result in a reduced number of relapses and severity of attacks. D)They reduce spasticity but have little effect on other signs/symptoms.

The preferred practice pattern (from the Guide to PT Practice)for patients with MS is A)5D Impaired motor function and sensory integrity associated with nonprogressive disorders of the CNS-acquired in adolescence or adulthood. B)5E Impaired motor function and sensory integrity associated with progressive disorder of the CNS-acquired in adolescence or adulthood. C)5F Impaired peripheral nerve integrity and muscle performance associated with peripheral nerve injury. D)5G Impaired motor function and sensory integrity associated with acute or chronic polyneuropathies.

Which of the following statements is true with regard to ambulation/mobility in people with MS? A)Most people diagnosed with MS lose the ability to ambulate within 5 years of onset of symptoms. B)Orthotic devices are not commonly used in patients with MS because their added weight increases fatigue,subsequently decreasing function. C)Most patients will require a wheelchair for mobility. D)Canes,forearm crutches,and walkers are all appropriate assistive devices for patients with MS with limitations in gait.

Aquatic therapy programs and water aerobics A)are not frequently used in patients with MS because of the fear and anxiety related to risk of drowning. B)can be an appropriate and effective intervention because the water provides graded resistance to movement while the buoyancy aids balance. C)should be done in warm pools; the warm temperature reduces spasticity. D)should be used only as a last resort because of the time/expense required with aquatic programs.

During an acute exacerbation patients with MS should A)continue with their typical levels of exercise or ambulation; this will help to decrease the severity of the exacerbation. B)adjust their exercise and activity levels; they will fare better if they allow themselves to rest for a few days. C)be placed on absolute bedrest; activity during the exacerbation will increase the severity of symptoms. D)increase their activity level; activity will help shorten the exacerbation period.

Which of the following are appropriate exercise guidelines for patients with stable MS? A)Only active movements should be included in the exercise programs; resisted exercises are contraindicated. B)Brief but maximal exercise periods are recommended to increase strength without causing overwork injuries or fatigue. C)Group exercise programs are rarely if ever indicated for patients with MS,as they tend to benefit more from one-on-one interaction with a therapist. D)Exercise sessions should involve discontinuous work that allows a balance of rest and exercise.

Management of fatigue in patients in MS can be best addressed by A)teaching patients activity pacing and energy conservation techniques. B)discontinuing participation in all aerobic exercise. C)using a knee-ankle-foot orthosis to stabilize LE muscles use during ambulation. D)discontinuing all strength training.

Which of the following is true with regard to the use of disease-specific measures in the examination/evaluation of patients with MS? A)There are no disease-specific instruments that can be used in the examination/evaluation of patients with MS. B)The Functional Independence Measure is an instrument that was developed specifically for patients with MS to measure functional abilities. C)The Expanded Disability Status Scale was developed to assess disability in patients with MS. D)The Multiple Sclerosis Function Mobility Scale was developed specifically to assess mobility in patients with MS.