GMCH Chandigarh - 2019
Medical Surgical Nursing
Easy
Which of these assessment findings should the nurse expect to identify as an early clinical characteristic of multiple sclerosis (MS)?
Appeared in: GMCH Chandigarh - 2019
Explanation
- The most common early clinical characteristic of Multiple Sclerosis (MS) among the given options is vision loss.
- This is because optic neuritis, an inflammation of the optic nerve, is a frequent initial presentation of MS.
- Symptoms of optic neuritis include blurred or dim vision, decreased color perception (especially red), and pain with eye movement.
- Double vision (diplopia) is another common early visual symptom due to the involvement of nerves controlling eye muscles.
Why Other Options Were Wrong
- Option A: Dementia, which is a severe decline in cognitive function, is not an early characteristic of MS. While mild cognitive issues can occur, dementia is a rare and late-stage complication.
- Option B: Muscle atrophy is the wasting away of muscle tissue. In MS, it is a secondary symptom that occurs late in the disease due to disuse from chronic weakness and immobility, not an initial sign.
- Option D: Clonus is a series of involuntary, rhythmic muscle contractions and is a sign of significant spasticity and upper motor neuron damage. It is typically seen in more advanced stages of MS, not at the onset.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Early clinical manifestations of Multiple Sclerosis (MS) to guide bedside assessment, documentation, and the next nursing action.
- A nurse assessing a young adult, especially a female, presenting with sudden unilateral vision loss and eye pain should maintain a high index of suspicion for MS and facilitate a prompt neurological referral.
- Patient education is key. A patient newly diagnosed with MS should be taught to recognize and report new or worsening symptoms, including visual changes, as they may indicate a relapse requiring intervention.
- What if? If the patient presented with ascending paralysis and weakness over a few days, the primary differential diagnosis would shift from MS to Guillain-Barré Syndrome (GBS), which affects the peripheral nervous system.
How to Approach the Question
- First, analyze the question stem to identify the key elements: the condition ('multiple sclerosis') and the time frame ('early clinical characteristic').
- The word 'early' is critical. It requires you to differentiate between initial presenting symptoms and complications that develop over time.
- Evaluate each option based on your knowledge of MS pathophysiology. MS is a demyelinating disease of the central nervous system.
- Recall that the optic nerve is part of the CNS and is commonly affected early in MS, leading to vision problems. This makes 'Vision loss' a strong candidate.
- Consider the other options: Dementia, muscle atrophy, and clonus are all associated with neurological damage but are typically consequences of disease progression, not initial signs.
- Select the option that represents a common, initial demyelinating event, which is vision loss due to optic neuritis.
Concept Tested & Keywords
- Concept Tested: Early clinical manifestations of Multiple Sclerosis (MS)
- Stem keywords: assessment findings, early clinical characteristic, multiple sclerosis, MS
- Lead-in keywords: expect to identify
Question ID
Q97sU3FawDuB5Fp2ODfKa1
Reference Book
E6 Medicine Harrison 22e Part 2 p. 1482-1484
E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart B (pp 240-463 of 478) p. 128-130
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 1921-1923
Practise the full GMCH Chandigarh - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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