Pathophysiology: Multiple Sclerosis

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Pathophysiology
“ Multiple sclerosis cam be defined as an autoimmune disease that affects the myelin sheath and conduction of pathway of the nervous system (CNS). It is one of the leading causes of neurologic disabilities in young adults. It is a chronic disease that is characterized by periods of remission and exacerbation.” (Ignataviscius & Workman, 2013, p. 978) Multiple sclerosis affects all patient’s differently, progressing at different rates over different periods of time. “As the severity and duration of the disease progress, the periods of exacerbation become more frequent, however patient’s with MS have a normal life expectancy as long as the effects of the disease are treated.” (Ignataviscius & Workman, 2013, p. 978)
Clinical Manifestations/
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This type of MS is seen in only a small percentage of patient’s. Progressive, cumulative symptoms and deterioration occur over several years.” (Ignataviscius & Workman, 2013, p. 978) (Ignataviscius & Workman, 2013, p. 978)
Etiology
The exact cause of MS is unknown and is very complex.
• Viruses are recognized as causes of demyelination and inflammation, making it possible that a virus or other infectious agent can trigger MS. Though no single virus has been identified as causing MS in a genetically predisposed person. (Ignataviscius & Workman, 2013, p. 979)
• MS is often seen in colder climates of the northeastern, Great lakes and the specific northwestern states, making the environment a possible MS trigger.
• Familial patterns of Multiple Sclerosis have been identified through large genome studies of families.
• Recent research also confirms the association of Multiple Sclerosis with interleukin (IL)-7 and (IL)-2 receptor genes, as well as other interleukin genes including, B-lymphocytes, and B-cells to play an important role in the more progressive forms of the disease. (Ignataviscius & Workman, 2013, p. 979)
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The collective results of a variety of tests are usually conclusive (Ignataviscius & Workman, 2013, p. 979).”
• Abnormal cerebrospinal fluid (CSF) findings include, an elevated protein level and a slight increase in white blood cell count.
• CSF electrophoresis reveals an increase in the myelin basic protein and the presence of increased immunoglobulin’s, especially IgG, which IgG bands are seen in most MS patient’s.
• CT Scan to show an increased density in white matter and MS plagues.
• MRI shows the presence of plaques .
• Results of visual, auditory, and brainstem evoked potential studies are often abnormal.
• Electromyography (EMG) findings may be very abnormal in people with advanced stages of the disease. (Ignataviscius & Workman, 2013, p. 979)
V.C. Labs
Upon admission to the hospital labs were taken to determine my patient’s chemistry, her hematology, and her urinalysis.
• Chemistry
• Sodium (NA)- 140mmol/L (range 135-145 mmol/L)
• Potassium (K)-3.8mmol/L (range

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