RHS 350 Exam 2

What are the patterns and progression types of MS?

• Relapsing-Remitting (RRMS): Most common; periods of relapse followed by remission.

• Secondary Progressive (SPMS): Begins as RRMS, then progresses steadily.

• Primary Progressive (PPMS): Steady worsening from onset, no distinct relapses.

• Progressive-Relapsing (PRMS): Progressive disease with occasional relapses.

What physical and functional manifestations of MS affect mobility and daily life?

Muscle weakness, spasticity, tremor, ataxia, fatigue, visual disturbances, bladder/bowel issues, and heat sensitivity.

What work-related difficulties may result from MS symptoms and fatigue?

Reduced endurance, inconsistent performance, cognitive slowing, difficulty with concentration, and need for flexible scheduling or remote work.

What are major treatment and management approaches for MS?

• Disease-modifying therapies (DMTs): e.g., interferon-beta, glatiramer acetate.

• Symptom management: physical therapy, fatigue and pain management.

• Rehabilitation: OT/PT, mobility aids, counseling.

What psychosocial challenges arise from invisible MS symptoms?

Others may underestimate limitations; feelings of isolation, frustration, depression, or stigma due to “invisible” fatigue or cognitive changes.

What cognitive and psychological changes can accompany MS?

Impaired memory, attention, executive functioning, emotional lability, depression, and anxiety.

What health vulnerabilities or complications can occur in MS?

Urinary tract infections, pressure sores, respiratory infections, osteoporosis from immobility.

What motor coordination issues result from neurological changes in MS?

Ataxia, tremor, spasticity, loss of balance, and fine motor difficulties.

What medications/interventions reduce MS symptom severity?

Corticosteroids (relapses), muscle relaxants (spasticity), DMTs, antidepressants, and PT/OT for function.

What are key features of Myasthenia Gravis?

Autoimmune disorder causing muscle weakness that worsens with activity; affects eyes, face, swallowing, and breathing muscles.

What are early manifestations of Huntington’s Disease?

Subtle mood changes, irritability, depression, clumsiness, chorea (involuntary movements), and cognitive decline.

What are motor manifestations of Parkinson’s Disease?

Resting tremor, rigidity, bradykinesia (slowness), postural instability, shuffling gait.

What are major management strategies for Muscular Dystrophy?

Physical therapy, assistive devices, respiratory support, corticosteroids, and adaptive education/vocational supports.

How is ALS managed?

Supportive care, ventilatory assistance, speech therapy, riluzole or edaravone to slow progression, and adaptive equipment.

What characterizes Alzheimer’s Disease progression and cognitive decline?

Gradual memory loss → impaired reasoning → language decline → loss of self-care → severe dementia.

What supportive interventions promote adjustment and QoL in Alzheimer’s?

Structured routines, memory aids, caregiver support, safe environment, and meaningful activities.

What are common pharmacologic treatments for Parkinson’s Disease?

Levodopa/carbidopa, dopamine agonists, MAO-B inhibitors, and anticholinergics.

What is the core feature set of parkinsonism?

Tremor, rigidity, bradykinesia, and postural instability.

What are key motor characteristics of Cerebral Palsy?

Spasticity, ataxia, dyskinesia, abnormal reflexes, poor coordination, and posture control issues.

What are risk factors/causes of CP by period?

• Prenatal: Infections, maternal illness, toxins.

• Perinatal: Birth asphyxia, prematurity.

• Postnatal: Head injury, meningitis.

What medical and sensory complications are common in CP?

Seizures, vision/hearing impairments, feeding difficulties, scoliosis, and intellectual disabilities.

What functional/vocational considerations exist for individuals with CP?

Accessibility, adaptive equipment, workplace modifications, fatigue management, and advocacy for inclusion.

What are typical manifestations of Spina Bifida?

Muscle weakness/paralysis, hydrocephalus, bowel/bladder dysfunction, orthopedic issues.

What are the types of Spina Bifida?

• Occulta: Mild, hidden defect.

• Meningocele: Sac with meninges.

• Myelomeningocele: Most severe; includes spinal cord → paralysis and sensory loss.

How does lesion level affect Spina Bifida function?

Higher lesions = greater paralysis and functional limitations; lower lesions = more independence.

What is the purpose of medications for psychotic disorders?

Reduce hallucinations, delusions, and disorganized thinking by modulating dopamine (antipsychotics).

What are positive and negative symptoms of schizophrenia?

• Positive: Hallucinations, delusions, disorganized speech.

• Negative: Apathy, flat affect, social withdrawal.
  → Impact: impaired functioning, communication, and social interaction.

What defines mood instability in bipolar disorder?

Alternating episodes of mania/hypomania and depression.

How do Bipolar I and II differ?

• Bipolar I: Full manic episodes.

• Bipolar II: Hypomanic episodes with major depression.

Difference between factitious disorder and malingering?

• Factitious: Faking illness for attention.

• Malingering: Faking illness for external gain (e.g., money, avoidance).

Major types of psychological testing for psychiatric assessment?

Personality (MMPI), intelligence (WAIS), projective (Rorschach), neuropsychological tests (memory, attention).

What are nonpharmacologic/community approaches in psych rehab?

CBT, group therapy, supported employment, case management, and social skills training.

What is the use of electroconvulsive therapy (ECT)?

Treats severe depression, catatonia, or treatment-resistant conditions.

What functional implications and lifestyle adjustments accompany psychiatric disorders?

Medication adherence, stress management, structure, support systems, and workplace accommodations.

What are typical manifestations of Cushing’s Syndrome?

Moon face, central obesity, muscle wasting, hypertension, skin thinning, osteoporosis.

What are vocational safety concerns in diabetes?

Hypoglycemia risk (especially for drivers/operators), need for regular meals and glucose monitoring.

How does the hypothalamic–pituitary axis regulate endocrine function?

Hypothalamus releases hormones → stimulate pituitary → release tropic hormones → activate target glands (thyroid, adrenals, gonads).

Difference between microvascular and macrovascular complications of diabetes?

• Microvascular: Retinopathy, nephropathy, neuropathy.

• Macrovascular: Heart disease, stroke, peripheral vascular disease.

Core principles of insulin therapy in type 1 diabetes?

Replace insulin physiologically (basal + bolus), match doses to carbs/activity, prevent hypo-/hyperglycemia.

How do endocrine hormones maintain homeostasis?

By regulating metabolism, growth, stress response, and reproduction through feedback loops.

What are nutrition goals in diabetes management?

Maintain glucose control, balanced carbs, consistent meals, weight management, and avoid extremes.

How do Type 1 and Type 2 diabetes differ pathophysiologically?

• Type 1: Autoimmune destruction of β-cells → no insulin.

• Type 2: Insulin resistance + relative deficiency.

Key differences between hyperthyroidism (Graves’) and hypothyroidism?

• Hyperthyroidism: Weight loss, heat intolerance, anxiety, goiter.

• Hypothyroidism: Weight gain, cold intolerance, fatigue, slow cognition.

How is diabetes mellitus identified and confirmed?

Fasting glucose ≥126 mg/dL, A1C ≥6.5%, or 2-hour OGTT ≥200 mg/dL.