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MOHD4 Exam 4 Brain Stuff > Movement Disorders/Cerebellar Disorders and Ataxia > Flashcards

Movement Disorders/Cerebellar Disorders and Ataxia Flashcards

1
Q

T/F: Parkinson’s Disease is a hypokinetic but also has action tremors and dyskinesia

A

False. Parkinson’s Disease is a hypokinetic but also has RESTING tremors and dyskinesia

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2
Q

Most common movement disorder

A

Tremor

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3
Q

Name the type of tremor:

tremor produced during voluntary contraction of muscle

A

Action

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4
Q

Name the type of tremor:

tremor present while voluntarily maintaining a position against gravity

A

Postural

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5
Q

Name the type of tremor:

tremor occurring during any voluntary movement

A

Kinetic

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6
Q

Name the type of tremor:

tremor occurring during target directed movement

A

Intention. Subtype of kinetic

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7
Q

Name the type of tremor:

tremor that occurs in body part that is not voluntarily activated and completely supported against gravity

A

Resting tremor

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8
Q

Name the type of tremor:

tremor easily visible, mainly postural with NO underlying neurological disease

A

Enhanced physiologic

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9
Q

Most common type of tremor

A

Essential Tremors (ET)

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10
Q

T/F: Essential tremor is characterized by unilateral, mainly postural or kinetic tremor involving feet.

A

False

BIlateral, mainly SYMMETRIC postural or kinetic tremor involving HANDS and FOREARMS

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11
Q

Pathophysiology of Essential Tremor

A

Impaired GABA-ergic inhibitory cerebellar output

Increased activity in cerebellothalamocortical circuit

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12
Q 
Medication used to treat essential tremor include ALL except:
A. Beta blocker
B. Anti seizure drugs
C. Muscle relaxants
D. Benzodiazepines
A

C

Beta blocker: propranolol
Anti-seizure drugs: primidone, gabapentin, topiramate
Benzodiazepines: clonazepam

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13
Q

4 cardinal features of Parkinson’s Disease

A

Tremor at rest (asymmetric)
Bradykinesia
Rigidity
Postural instability

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14
Q

BRAAK staging of Parkinson’s

Preclinical presents with ____ in ____

A

Lewy bodies
Olfactory bulb –> anosmia
Medulla, pons

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15
Q

BRAAK staging of Parkinson’s

Clinical presents with ____ in ____

A

Lewy bodies
Midbrain (substantia nigra)
Basal forebrain

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16
Q

BRAAK staging of Parkinson’s

Late disease presents with ____ in ____

A

Lew bodies

Neocortex

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17
Q

T/F: Chorea is characteristic of involuntary, irregular, purposeless, asymmetric, non-rhythmic movements that gets better with activity and usually involves distal lower extremities

A

False. WORSEN with activity

distal UPPER extremities

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18
Q

Name the type of Chorea:
• Involuntary writhing, dance like movements
• Onset after infection (Group A streptococcus)
• Problems concentration
• Impulsivity
• Resolves over time

A

Sydenham Chorea

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19
Q

Which of the following is TRUE about the pathophysiology of Huntington Disease?
A. Increased GABA-ergic input to medial globus pallidus
B. Decreased inhibition of subthalamic nucleus
C. Increased tonic activity on lateral globus pallidus and substantia nigra pars reticularis
D. Increased glutaminergic stimulation of cerebral cortex

A

D

A. Decreased, lateral globus pallidus
B. Increased
C. Reduced, medial globus pallidus

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20
Q

Psychiatric symptoms of Huntington’s Disease possibly due to pathology in ____

A

medial anterior caudate

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21
Q 
Treatment of Huntington's Disease include all of the following EXCEPT:
A. Haloperidol
B. Tetrabenazine
C. Propranolol
D. Sertraline
E. Buspirone
F. Levodopa
A

F. Levodopa used to treat Parkinsonism features of juvenile onset HD

A. dopamine-blocking drug
B. Dopamine depleting agent
C, D, E: for irritability/aggression

22
Q

Dystonia results in disorder of ____

A

basal ganglia function

23
Q

Dystonia is treated with:

A

Botox for focal or segmental
Anticholinergic: trihexiphenidyl, benztropine
Muscle relaxant
Deep brain stimulation of globus pallidus interna

24
Q

Head or truncal oscillation (axial tremor) =

A

Titubation

25
Q

Difficulty with target directed movement (finger to nose) (Overshoot or undershoot target) =

A

Dysmetria

26
Q

Inability to coordinate single joint movements=

A

Dysrhythmia

27
Q

Inability to coordinate multiple joint movements =

A

Dysdiadochokinesia

28
Q

Decreased resistance to passive muscle stretch

A

Hypotonia

29
Q

Pendular reflexes =

A

multiple oscillation

30
Q

Inability to perform the Romberg test with eyes open suggests ___ dysfunction

A

cerebellar

31
Q

Inability to perform the Romberg test with eyes closed suggests ___ dysfunction

A

dorsal column or peripheral nerve

32
Q

Which of the following is FALSE about sensory ataxia?
A. Impaired feedback of position sense to coordinate movements
B. Romberg: unable to perform when eyes open
C. Dorsal column or peripheral nerve dysfunction

A

B. when eyes CLOSED

33
Q

Which of the following is FALSE about vestibular ataxia?
A. Impaired sense of head movement
B. Lack of orientation w/ respect to gravity
C. Gait and balance difficulty
D. Incoordination of limbs or speech

A

D. NO incoordination of limbs or speech

34
Q

Name the type of cerebellar ataxia:
o Impaired equilibrium = postural instability/titubation
o Difficulty with eye movements
o Romberg: unable to perform with eyes open

A

Vestibulocerellum

Flocculonodular lobe

35
Q

Name the type of cerebellar ataxia:

Truncal ataxia: “drunken sailor gait”

A

Spinocerebellum

Vermis/midline structures

36
Q

Name the type of cerebellar ataxia:
Appendicular ataxia: Disruption of fine motor movements and limbs
Dysarthria

A

Cerebrocerebellum

Lateral hemisphere

37
Q

Name the disease:

Mutation of FXN gene → decreased frataxin protein production

A

Friedrich’s Ataxia

38
Q

Which of the following is FALSE about pathophysiology of Friedrich’s Ataxia?
A. PNS degneration of sensory fibers
B. CNS degeneration of spinal cord and parietal cortex
C. Ataxia due to proprioceptive loss

A

B. spinal cord and spinocerebellar tract

39
Q 
Which of the following is NOT a symptom of Friedrich's Ataxia?
A. Scoliosis
B. Lose of ability to walk
C. Abnormal ocular movement
D. Diabetes
E. Cardiomyopathy
F. Dysarthria 
G. Loss of proprioception in feet
H. None of the above
A

H

40
Q

Multiple System Atrophy shows ___ on MRI

A

atrophy of cerebellum and brainstem

41
Q

Multiple System Atrophy is caused by degeneration of (3)

A

Cerebellum
Pons
Inferior olives

42
Q

Which of the following is FALSE about Multiple System Atrophy?
A. Weakness
B. Autonomic dysfunctions (incontinence, orthostasis)
C. Parkinsonism
D. Dementia
E. Cerebellar ataxia
F. Visual impairment

A

F

43
Q 
Drug induced cerebellar syndrome includes all of the following EXCEPT:
A. Transient gait ataxia
B. Sensory ataxia
C. Dysarthria
D. Nystagus
A

B

44
Q

Vitamin B12 deficiency causes what kind of ataxia?

A

o Dorsal column degeneration → Sensory ataxia

o Spinocerebellar tract degeneration → cerebellar ataxia

45
Q

Acute vitamin B1 deficiency causes what kind of ataxia?

A

Gait ataxia

Wernicke-Korsakoff

46
Q

Chronic vitamin B1 deficiency causes what kind of ataxia?

A

Truncal ataxia

Cerebellar cortical degeneration

47
Q

Vitamin E deficiency causes ____ degeneration

A

spinocerebellar

48
Q

anti-Yo =

A

Anti-Purkinge cell antibodies → loss of Purkinje cells and cerebellar atrophy –> Multiple System Atrophy
In Ovarian/breast cancer

49
Q

anti-Hu =

A

Anti-Purkinge cell antibodies → loss of Purkinje cells and cerebellar atrophy –> Multiple System Atrophy
In small cell lung cancer

50
Q

T/F: Gluten ataxia causes reversible cerebellum damage

A

False. Irreversible

51
Q

T/F: Unilateral stroke causes contralateral symptoms

A

False. Ipsilateral

MOHD4 Exam 4 Brain Stuff (11 decks)

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