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Clin Med 3 Final Exam > Lecture 3-movement disorders > Flashcards

Lecture 3-movement disorders Flashcards

1
Q

a state of restlessness

A

akathisia

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2
Q

inability to coordinate movements of the trunk or limbs

A

ataxia

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3
Q

involuntary writhing limb movements

A

athetosis

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4
Q

flailing, ballistic, involuntary movements in a limb

A

ballism

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5
Q

quick, involuntary, dance-like movements

A

chorea

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6
Q

involuntary movements, chorea-like or tic-like

A

dyskinesias

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7
Q

abnormal muscle tone with sustained posture

A

dystonia

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8
Q

involuntary, spasmodic, jerky movements

A

myoclonus

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9
Q

habitual, semi-voluntary, spasmodic, quick, brief movements

A

tics

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10
Q

involuntary, rhythmic, repetitive movement

A

tremor

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11
Q

2nd most common neurodegenerative disease following alzheimer’s

A

idiopathic parkinson’s disease

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12
Q

when do motor complications appear in idiopathic parkinson’s disease

A

~5-7 years after disease

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13
Q

do you see an overactive or underactive indirect pathway in IPD?

A

overactive

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14
Q

4 cardinal features of IPD

A
  • rest tremor (unilateral)
  • rigidity
  • akinesia-bradykinesia
  • postural instability (later sx)
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15
Q

unified parkinson’s disease rating scale

A

I: mentation, mood, and behavoir
II: ADLs
III: motor exam
IV: complications of therapy

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16
Q

drug-induced parkinsonism

A
  • offending drug (anti-nausea, anti-psychotics)
  • absence of rest tremor
  • SYMMETRIC sxs
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17
Q

vascular disease (diff. from parkinsonism)

A
  • GAIT DISTURBANCE (magnetic gait)
  • SPASTICITY
  • hyper-reflexia
  • pseudobulbar affect
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18
Q

normal pressure hydrocephalus

A

-APRAXIA OF GAIT
-regidity
urinary incontinence

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19
Q

corticobasal degeneration

A
  • COGNITIVE DISORDER
  • limb apraxia
  • dystonia or myoclonus
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20
Q

progressive supranuclear palsy

A
  • pseudobulbar affect
  • supranuclear gaze palsy
  • early falls
  • absence of tremor
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21
Q

multi-system atrophy

A
  • falls
  • axial dystonia
  • resp. stridor
  • absence of rest tremor
  • prominent autonomic features early on
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22
Q

dementia with lewy bodies

A
  • cognitive disorder

- hallucinations

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23
Q

workup for suspected parkinsonism

A
  • none if typical presentation

- MRI if gait disorder/falling, cognitive disorder

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24
Q

hot cross bus sign

A

MSA (multi-system atrophy)

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25
hummingbird sign (thinning of midbrain)
PSP (progressive supranuclear palsy)
26
when should you r/o wilson's disease?
any pt
27
workup for wilson's ds
urine copper and serum ceruloplasmin | -ophth=K-F rings
28
lab study for any pt with a tremor
thyroid studies
29
lab you should get in all patients you follow with PD
vitamin D
30
study for pts with dysphagia
swallow study
31
study for all pts with a voice change
speech evaluation
32
tx for IPD
- Sinemet (L-dopa and carbidopa) | - DA agonists (pramipexole, ropinirole, rotigotine)
33
who should take sinemet
all pts with IPD over the age of 70
34
unique SE of DA agonists
impulse control disorders
35
indications for DA agonists
pts
36
sx tx for IPD
- MCI/dementia= anticholinesterases - depression/anxiety= antidepressants - constipation=increase fiber - orthostatic hypoTN=caffeine, water, stockings - sialorrhea= robinul (caution) or botulinum
37
IPD surgical tx
- ablative | - DBS
38
indications for DBS
-significant disability, motor fluctuations with max medications, still levodopa responsice, no cognitive impairment
39
indication for Vim DBS
ET or tremor predominant PD
40
indication for STN DBS
PD
41
indication for GPi DBS
dystonia or rigidity prominent PD
42
autosomal dominant inheritance with variable penetrance
essential tremor
43
features of essential tremor
- typically BUE - rest tremor later on - may improve with alcohol
44
treatment for ET
wrist weights, propranolol, primidone, gabapentin, topiramate, etc
45
criteria for RLS
- abnl sensations with urge to move the legs - occurs at rest - alleviated by movement - sxs worse at night
46
secondary causes of RLS
neuropathy, Fe deficient, pregnancy, renal failure
47
Tx of RLS
- only use at night! | - Fe replacment, DA agonists, anti-epileptics, benzos, opioids,
48
chromosome involved with huntington's disease
chromosome 4 | -trinucleotide repeat (CAG)
49
autosomal dominant with HIGH penetrance
huntington's disease
50
butterfly appearance of ventricles
huntington's disease
51
manifestations of HD
- chorea, motor impersistence - cognitive deficits - psych (depression, suicide rate 5x general population)
52
tx of HD
- anti-dopaminergic drugs - benzos - anti-depressants
53
Tics are a/w which other disorders
OCD and ADD
54
etiology of Tics
- primary: tourette's - drug induced: stimulants, steroids, neuroleptics - post-infectious: post-strep
55
tx of Tics
- clonidine - neuroleptics - benzo
56
criteria for tourette's syndrome
- motor tics and phonic tics for >1 year - no secondary causes - onset before age 18 - copralalia (swearing)
57
tx of tourette's syndrome
meds, botox, DBS
58
types of primary dystonia
- generalized (childhood onset) | - focal (adult onset)
59
types of secondary dystonia
- neurocog. disorders | - medication
60
tx of dystonia
- dopaminergic - muscle relaxers - benzos - anticholinergics
61
what is a hemifacial spasm
involuntary, intermittent spasms of half of the face
62
triggers of hemifacial spasm
bright light, wind, fatigue, stress, smiling, speaking
63
most common cause of HFS
CN 7 compression
64
dx of HFS
clinical and MRI
65
tx of HFS
botox
66
clinical features of functional/psychogenic movement disorders
- abrupt onset with rapid progression - bizzare movement - spontaneous remissions - self inflicted injuries - give wat weakness - lateralization of tuning fork on frontal bone - hoover sign - astasia-abasia

Clin Med 3 Final Exam (6 decks)

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