Neurology 14

Question 1

Parkinson’s Disease presents with what 4 classic symptoms?

Answer 1

1. Tremor - 3-5 hz “pill rolling”
2. Rigidity (Cogwheeling)
3. Bradykinesia
4. Postural instability or loss of postural reflexes

Question 2

Other than classic TRAP symptoms of Parkinsons, what other symptoms can you see?

Answer 2

1. Masked faces
2. Decreased blinking
3. Micrographia
4. weight loss
5. Constipation
6. Dysphagia
7. Shuffling small step gait
8. Autonomic dysfunction (Sweating, orthostasis, urinary retention)

Question 3

Botulism occurs when C. Botulinum is ingested, and an exotoxin is released into the blood stream…

What are the classic symptoms?

Answer 3

dysphagia
dysarthria 
ptosis 
diplopia 
urinary retention 
N/V/D
.....eventually progresses to rapid progressive limb paralysis and death due to respiratory paralysis.

Question 4

What is Meige’s syndrome?

Answer 4

Condition of unknown etiology where you have a combination of blepharospasm (involuntary eye blinking) and oromandibular dystonia.

Question 5

Scanning speech, an irregular and choppy rhythm of speech is due to a lesion in what part of the brain?

Answer 5

CEREBELLUM

also referred to as cerebellar “dysmetria” of speech

Question 6

Define the following terms:

1. Aphemia
2. Aphasia
3. Agnosia
4. Apraxia
5. Abulia

Answer 6

Aphemia = motor speech disorder causing near muteness with normal reading, writing and comprehension.

Aphasia = broad term used to describe any disorder of language.

Agnosia = Inability to recognize and identify objects.

Apraxia = Inability to perform a skilled, learned motor task

Abulia = state of diminished motivation, presenting as severe apathy, affective blunting and immobility.

Question 7

In the continuum from alert and coma…you have stupor…

What is the definition of STUPOR?

Answer 7

A state of unresponsiveness from which arousal occurs only with vigorous and repeated stimulation.

Question 8

Cerebellar damage causes contralateral or ipsilateral deficits?

Answer 8

Ipsilateral

Question 9

What area of the brain accounts for:

1. Emotional Memory?
2. Declarative or episodic memory (short-term)?

Answer 9

1. Amygdala

2. Hippocampus and parahippocampus

Question 10

What is Hoover’s sign?

Answer 10

A patient suspected of psychogenic hemiparesis, the examiner places hand under the paralyzed leg and asks the patient to raise the other leg. If the paralyzed leg pushed down then hoover’s sign is positive.