MULTIPLE
SCLEROSIS
Scientist and Scholar
Q1
-
Horizontal
Partner and Team Player
nystagmus,
dysarthria, and ataxic gait suggest a
Kind and Compassionate
Professional
Q2 - Simply documenting the plan
Q3 - Frustration and feeling
and providing vague safety-netting
overwhelmed are common
advice fails to address:
experiences for patients with
lesion in the dorsal pons
The patient’s confusion
multiple sclerosis (MS)
The dorsal pons contains neural
Their emotional state
MS carries a high emotional toll in
pathways
Their need for understanding
addition to physical symptoms
responsible
for
eye
movements and coordination
While education is important, offering
A compassionate multidisciplinary
can
written resources alone is insufficient
team (MDT) approach is essential
disrupt these pathways, leading to
It’s essential not to overlook the GP’s
This approach should address both
the observed symptoms
ongoing duty to support the patient
the physical and emotional aspects
locally
of the patient experience
Demyelination
in
this
area
Q4 - Plaques are a key macroscopic
feature of MS found on autopsy correct answer. Neurofibrillary
tangles → microscopic feature of
Alzheimer’s disease
Wavy collagen bundles → seen
microscopically in neurofibromas
Lewy bodies → microscopic feature of
Parkinson’s disease
Caudate nucleus atrophy →
macroscopic feature of Huntington’s
disease
Q5 - C (correct answer) shows
Q6 - In Australia, MS specialist nurses
kindness and professionalism:
play a key role within the
Acknowledges the patient’s
multidisciplinary team (MDT) for MS
distress
care
Takes symptoms seriously
They act as the primary point of
Plans appropriate investigations
contact for patients
A and D risk dismissing organic
Responsibilities include:
pathology
Coordinating care
B may escalate fear unnecessarily
Providing education
before confirming a diagnosis
Offering emotional support
E delays needed neurological
throughout the patient journey
assessment by attributing symptoms
to anxiety
Q10-A new MS diagnosis, especially
Q7- Interferon beta-1a is a disease-
Q8- Physiotherapists play a key role
in a young woman of reproductive
modifying therapy for MS
in managing:
age, carries a significant emotional
It reduces the frequency and severity
Mobility + balance + strength
burden
of relapses
Fall risk in MS patients
The most supportive and therapeutic
Acts by modulating the immune
They design individualised exercise
system:
and rehab programs to:
↓ Pro-inflammatory cytokines
Support independence
↑ Anti-inflammatory cytokines
Reduce risk of injury
approach as a doctor is to:
Listen without rushing
Ask open-ended questions
Validate the patient’s experience
Inhibits migration of activated T
While other healthcare professionals
Understanding what matters most to
cells into the CNS
contribute, physiotherapists have
the patient:
Helps slow disease progression, but
specialised training in clinical
Builds trust
does not reverse it
rehabilitation
Guides personalised care
planning
MULTIPLE
SCLEROSIS
Scientist and Scholar
Partner and Team Player
Kind and Compassionate
Professional
Q9 - Patient with relapsing-remitting
Q12- Methylprednisolone is the firstline treatment for acute MS relapses
Reduces inflammation
Q11-Following collaborative care, an
occupational therapist is the most
ideal and qualified to provide:
Shortens relapse episodes
Tips and advice for managing MS
Does not affect long-term
symptoms daily, especially in a
disease progression
Interferon beta-1a, natalizumab, and
glatiramer acetate are used as longterm disease-modifying therapies
(DMTs)
work setting
Other options may offer some benefit
but do not address the main concern
of day-to-day assistance
Therefore, they are not the primary
Plasmapheresis is considered
or most important action in this
second-line for acute relapse
scenario
management
MS (RRMS) presents with nonspecific symptoms (fatigue, urinary
urgency)
No new neurological deficits or MRI
changes, suggesting symptoms may
be due to stress, not an acute relapse
Discussing stress management
strategies and organising
psychological care:
Aligns with person-centred care
principles
Emphasizes addressing
psychosocial factors in MS
management
Q15 - MS is a chronic disease with
Q14 - Evidence shows
Q13 - Patient’s presentation is typical
significant physical, cognitive, and
multidisciplinary team (MDT) care:
of multiple sclerosis (MS):
emotional challenges
Improves quality of life
Relapsing neurological
These challenges can lead to
Reduces hospital admissions
symptoms
depression and anxiety
Helps patients stay employed
MRI shows lesions consistent
Emotional symptoms affect
and socially active
with CNS demyelination
relationships and occupations and
Enables early intervention for
Underlying pathology is an
require proactive management
autoimmune attack on
Mental health assessment and
Referral to a multidisciplinary MS
complications
oligodendrocytes
referrals to counseling,
clinic offers the most comprehensive,
This leads to loss of myelin in the
psychotherapy, or psychiatry are
patient-centered care
central nervous system
essential components of holistic MS
It addresses the full spectrum of MS-
care
related challenges
Some extra resources
https://www.osmosis.org/learn/Multiple_sclerosis
Neurology, A Visual Approach -
https://radiopaedia.org/articles/multiple-sclerosis
Neurology | A Visual Approach | Sunjay Parmar, Pamela Shaw | Taylor &
Lived experience of multiple sclerosis- https://www1.racgp.org.au/ajgp/2022/april/the-lived-experience-of-multiple-sclerosis
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