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Multiple Sclerosis Pathology & Case Study

Toni is a 32-year-old mother who has had multiple sclerosis for 5 years. She has been admitted for diagnostic studies related to visual disturbances. Multiple sclerosis is a progressive disease characterized by demyelination of the brain and spinal cord. Common signs are vision loss, vertigo, and muscle stiffness. During her interview, Toni minimizes her symptoms and talks about her goals, which the nurse recognizes as coping mechanisms. Areas frequently affected by multiple sclerosis include the optic nerve and chiasm. Toni's disease may involve the sacral plexus, so the nurse should assess for bladder, bowel, and sexual functioning. There are several disease-modifying medications that can reduce relapses, such

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111 views2 pages

Multiple Sclerosis Pathology & Case Study

Toni is a 32-year-old mother who has had multiple sclerosis for 5 years. She has been admitted for diagnostic studies related to visual disturbances. Multiple sclerosis is a progressive disease characterized by demyelination of the brain and spinal cord. Common signs are vision loss, vertigo, and muscle stiffness. During her interview, Toni minimizes her symptoms and talks about her goals, which the nurse recognizes as coping mechanisms. Areas frequently affected by multiple sclerosis include the optic nerve and chiasm. Toni's disease may involve the sacral plexus, so the nurse should assess for bladder, bowel, and sexual functioning. There are several disease-modifying medications that can reduce relapses, such

Uploaded by

Aleksei Cuadra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Worksheet 1 | Multiple Sclerosis

Part 1:

- The primary pathology of multiple sclerosis is damage to the: myelin loss within the Central
Nervous system
- Explain what demyelination refers to in reference to multiple sclerosis (simplified
pathophysiology based on your understanding) Several localized areas of myelin loss within the
CNS, known as plaques or lesions, are the pathologic feature of multiple sclerosis. These
plaques or lesions are accompanied by varied gliosis and inflammation as well as relative
axonal preservation. Macrophages with myelin debris are found inside active multiple
sclerosis lesions. limited to the primary CNS. Two fundamental processes constitute general
pathological process seen in MS patients: Focal inflammation resulting in macroscopic plaques
and injury to the blood-brain barrier 

Part 2. CASE STUDY: Multiple Sclerosis Toni, a 32-year-old mother of two, has had multiple sclerosis for 5
years. She is currently enrolled in a school of nursing. Her husband is supportive and helps with the care
of their preschool sons. Toni has been admitted to the clinical area for diagnostic studies related to
symptoms of visual disturbances.

1. The nurse is aware that multiple sclerosis is a progressive disease of the central nervous system
characterized by

a. axon degeneration. b. demyelination of the brain and the spinal cord.

c. sclerosed patches of neural tissue. d. all of the above.

2. The nurse knows that the three common clinical signs for MS are: Loss of vision, Vertigo and Muscle
Stiffness.

3. During the nursing interview, Toni minimizes her visual problems, talks about remaining in school to
attempt advanced degrees, requests information about full-time jobs in nursing, and mentions her
desire to have several more children. The nurse recognizes Toni’s emotional responses as being:

a. an example of inappropriate euphoria characteristic of the disease process.

b. a reflection of coping mechanisms used to deal with the exacerbation of her illness.

c. indicative of the remission phase of her chronic illness.

d. realistic for her current level of physical functioning

4. During the physical assessment, the nurse recalls that the areas most frequently affected by multiple
sclerosis are the:

a. lateral, third, and fourth ventricles.

b. optic nerve and chiasm.

c. pons, medulla, and cerebellar peduncles.

d. above areas.
5. Toni’s disease process involves a sacral plexus. Assessment should include:

a. bladder problems or urinary tract infections.

b. bowel management.

c. sex.

d. all of the above

6. The nurse knows that disease-modifying pharmacologic therapy can reduce the frequency and
duration of relapse. List five probable medications use to manage MS and provide atleast 1 important
effect of such medication:

Teriflunomide (Aubagio) - Teriflunomide selectively and reversibly inhibits dihydro-orotate


dehydrogenase, a key mitochondrial enzyme in the de novo pyrimidine synthesis pathway, leading to a
reduction in proliferation of activated T and B lymphocytes without causing cell death.

Dimethyl fumarate (Tecfidera) - Dimethyl fumarate is believed to act centrally by enhancing the nuclear
factor erythroid 2 related factor 2 (Nrf2) transcriptional pathway, which regulates enzymes to counter
act oxidative stress . DMF may enhance the Nrf2 transcriptional pathway within the CNS, 

Diroximel fumarate (Vumerity). - the active metabolite of diroximel fumarate, has been shown
to activate the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway in vitro and in vivo in animals
and humans. The Nrf2 pathway is involved in the cellular response to oxidative stress.

Fingolimod (Gilenya) -  used to treat the relapsing forms of multiple sclerosis (MS), including clinically
isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.

Siponimod (Mayzent). sphingosine 1-phosphate receptor (S1P) modulator that selectively binds the S1P
subtypes 1 and 5. It acts as a functional antagonist, as binding to S1P1 induces receptor internalization
and degradation in T and B cells.

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