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#DOOS Neuro > Lect 1 & 2 > Flashcards

Lect 1 & 2 Flashcards

1
Q

three components of CNS

A

(everything covered in dura mater) brain, spinal cord, and optic nerve (CN II)

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2
Q

4 components of PNS

A

motor, sensory, special sensory, and autonomic

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3
Q

what is neurology

A

the branch of med dealing with anatomy, fxns, and organic do of of CNS and PNS AND SKELETAL MUSCLES (this includes muscular distrophy)

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4
Q

most diagnoses are made by __________

A

history

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5
Q

akinesia

A

can’t initiate movement

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6
Q

dystonia

A

involt sustained contraction

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7
Q

rigidity

A

increased muscle tone

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8
Q

akathisia

A

inability to sit still

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9
Q

ballismus

A

large involt movemnt

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10
Q

chorea

A

small rapid movements flowing unpredictably from one body part to another

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11
Q

myoclonus

A

sudden breif movement of a muscle group

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12
Q

tic/stereotypy

A

compulsive/repeated movements/behaviors

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13
Q

ataxia

A

lack of muscle coordination

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14
Q

*dysarthria

A

difficulty with speech articulation

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15
Q

tremor

A

rythmic alternating of flexor.extensor

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16
Q

*all of us have a constant low level tremor called _____; this is increaced with stress, fatigue, or caffeine and is called ________

A

physiologic tremor

enhancer physiologic tremor

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17
Q

what is an essential tremor

A

BL tremor that appears during voluntary movement (aka action/kinetic tremor)
(gets worse with stress/fatigue)

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18
Q

Essential tremor typically gets more prominent with _____

A

age (4% of ppl over 40yo)

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19
Q

name the 3 treatments for essential tremor

A

Betablockers(proppranolol, nadolol)
anticonvulsives
deep brain stimulation
(also assistive devices and weighted utensils)

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20
Q

half of essential tremor pts inherited it (autosomal _______). what does essential tremor inc the risk of?

A

autosomal dominant

inc risk of parkinsons by 4x

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21
Q

what are the 3 main motor sx deemed “parkinsonisms”

A

resting tremor
cogwheel or lead pipe rigidity
bradykinesia
(other negative motor sxs)

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22
Q

PD is characterized by a slow _____(BL/UL) resting tremor that disappears with movement

A

UL

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23
Q

Does PD ascend or descend? symmetric?

A

descending

asymmetric

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24
Q

What is strange about bradykinesa of PD?

A

it is unequal for tasks

ex: pt cannot walk, but can ride a bike

25
Q

what is festination

A

rapid shuffling

26
Q

what are the neuropsych sx of PD (4)

A

cognitive disturbances (executive attn -poor decisions)
mood disturbances (depression, anxiety)
dementia inc risk 2-6x
Psychosis (usually iatrogenic)

27
Q

how do you dx PD?

A

Hx AND neurological examination (brain imaging unhelpful early on)

28
Q

Once you start L-Dopa you cannot stop…name sx of dose reduction/withdrawl (What it’s called and 4 sx)

A

Neuroleptic malignant-like syndrome

~Fever, akinetic crisis(can’t breathe), rigidity, autonomic disturbances (vomit uncontrollably)

29
Q

*What alternatives to L-Dopa tx should you consider FIRST?

A

Dopamine agonists
MAO-B inhibitors
Deep brain stimulation
pallidotomy (surgical dest to control dyskinesia)

30
Q

Doapamine agonists are similar to L-Dopa except that ____________. Why is it good to start with these drugs 1st?

A

they ghave worse side effects

Delaying L-Dopa and starting with these tx will reduce the severity of “off” states when taking L-Dopa later.

31
Q

_____________ increases your risk of PD.

_____, ______, and ______ dec your risk.

A

pestacide/insecticide exposure (farm)

coffee, NSAID use, and tobacco use

32
Q

Huntingtons is inherited __________. and is neurodegenerative dz with an insidious onset and a progressive course.

A

auto dom

33
Q

mild vs severe chorea

A

mild: restless, small unintentional movements, poor cordination, saccadic eye movements (can’t smoothly track)
severe: athetosis, rigidity, abnormal posturing

34
Q

name 4 sx of HD

A

ataxia
dysarthria
dysphagia
unstable gait

35
Q

what is genetic anticipation(HD)?

A

onset of dz is earlier with each generation

36
Q

HD is due to CAG repeats in DNA that are too long and wrap in on themselves… what’s the mnemonic for this?

A

CAG is a CAt who is a Glutton for glutamine with a really long tail.

37
Q

where do CAG repeats occur in HD

A

chromosome 4

38
Q

9-26 CAG repeats is normal. should you be worried about developing HD if you have 25 or 26 repeats?

A

No, there is no elevated risk in this range.

27-35 your KIDs might get it
36-40 you may or may not have it yourself
41-59 definitive you have DH
60+ is juvenile HD

39
Q

what is a tic

A

paroxysmal(sudden), stereotyped(same thing), nonrhythmic motor movement of vocalization.

40
Q

are tics involuntary?

A

no they are unvoluntary/semi-voluntary (like a sneeze, could hold in but hard)

41
Q

Tics may subside during ________ and don’t happen during ________

A

focused work

dont happen during sleep

42
Q

simple vs complex motor tics

A

simple- one motor group (blinking, shrugging)

complex - more than one motor group (pulling at clothes, echopraxia(repeat other ppls movements)

43
Q

simple vs complex vocal tics

A

simple - throat clearing, grunting, sniffing

complex - echolalia(repeating others), palilalia(repeat yourself), coprolalia (filthy words)

44
Q

how long does transient tic do last

A

4wks to 12 months (typically one month)

45
Q

how long does chronic tic do have to be

A

> 12 months

46
Q

what is tourette syndrome

A

a chronic MIXED tic do (both vocal and motor) [dont have to have them simultaneously]

47
Q

tics typically _______ and _______ not present all at once

A

wax and wane

48
Q

tics inc your risk for

A

other psych dos

49
Q

A high percentage of people with tics have _______ or _______

A

ADHD (63%)
OCD (34%)

If you treat these comorbidities it helps alleviate these tics

50
Q

what’s the best tx for tourettes? 2 other txs?

A

cognitive behavioral therapy

alpha 2 agonists and benzodiezapine

51
Q

what is delirium

A

acute cognitive impairment

52
Q

delirium onset is usually _________

the intensity is usually __________

A 
onset is hours or days
intensity fluctuates (causes attention deficits)
53
Q

how do you manage delirium?

A

tx underlying do (iatrogenic, infection, hypothyroidism, dehydration, anemia, liver dz, etc)

54
Q

what is dementia

A

chronic cognitive impairement

static or slowly progressive

55
Q

dementia typically has an insidious onset except for in cases of ________; ______ and ______ are the hallmarks

A

except stroke/trauma

memory loss and language deficits are the hallmark

56
Q

when is early onset dementia

A

before 65 yo

57
Q

Alzheimers comprises 80% of dementia in those >65yo and is progressive and is associated with __________ and _________ in the gray matter of the brain.

A

tangles (aggregates with intraneuronal tau protein)

plaques (extracellular deposits of beta amyloid)

58
Q

what is the tx for alzheimers? what do you need to consider?

A

caregiving is the main tx as there are no drugs to alter the course

this dz places a tremendous burden on care givers (therapy for caregivers sb considered)

#DOOS Neuro (6 decks)

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