Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABIM > Neurology-Movement-Disorders-and-others > Flashcards

Neurology-Movement-Disorders-and-others Flashcards

1
Q

Types of tremors: 5

A
  1. Resting
  2. Postural
  3. Action
  4. Postural-action
  5. Intention

Rhythmic and oscillatory movement of a body part with a relatively constant frequency and variable amplitude. It is caused by either alternating or synchronous contractions of antagonistic muscles

Tremors may be broadly classified into resting, postural, action, postural-action, and intention tremors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tremor present when holding up a newspaper versus when pouring a cup of tea

A

Postural versus Action

Postural tremors occur with the body part suspended against gravity. Action tremors remain unchanged during the course of a voluntary movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

also known as cerebellar tremor, is a dyskinetic disorder characterized by a broad, coarse, and low frequency (below 5 Hz) tremor. The amplitude increases as an extremity approaches the endpoint of deliberate and visually guided movement

A

Intention tremor

(kinetic tremor subtype)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

involuntary, rhythmic oscillations of one or more body parts

A

Tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Differentiate ET from Parkinsons’: parameters

A
  1. Laterality: Parkinson’s is unilateral
  2. Action vs rest
  3. Alcohol response: improves ET, no effect in Parkinson’s
  4. Speed: Fast (6-10) hz, Slow (4-6) hz
  5. Movement: flexion-extension, pill rolling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which tremor has a genetic component?

A

ET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. Involuntary excessive muscle contractions that tend to be sustained and patterned,
  2. initiated or worsened by voluntary action and associated with overflow muscle activation
  3. abnormal postures or movement
  4. dysfunction of the basal ganglia, cerebellum, cortex
A

Dystonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drug groups causing dystonias

A
  1. Anti-emetics
  2. Anti-psychotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Stroke in this part can cause dystonia

A

Putamen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dystonia classification basis

A

Body part affected

Eg: spasmodic dysphonia: vocal cords,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatable causes of dystonia

A
  1. Wilson’s
  2. Dopa-responsive dystonia
  3. DYT1 gene–associated dystonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rx: focal dystonias

A

Botulinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the putamen?

A

This is a transverse section of the striatum from a structural MR image. The striatum includes the caudate nucleus (top) and putamen (right) and the globus pallidus (left).

The putamen and caudate nucleus together form the dorsal striatum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Involuntary, irregular, unpatterned, and unsustained movements with variable timing and distribution

A

Chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Involuntary slow and irregular writhing movements most often affecting the distal limbs

A

Athetosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Involuntary, large-amplitude, flinging movements, typically involving proximal muscles that move an entire limb

A

Ballism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Autosomal dominant inheritance with gene test for triplet nucleotide repeat. Chorea, psychiatric symptoms, and cognitive dysfunction progress over 10 to 20 years until death.

A

Huntington

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Strokes in this basal ganglia nucleus will cause choreoathetoid movements

A

sub-thalamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

disorder of childhood resulting from infection via Group A beta-hemolytic streptococcus (GABHS), characterized by rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles

A

Sydenham’s chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Prognosis of chorea from stroke

A

Ofent improves on its own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drug-induced movement disorders can include

A
  1. Tremor
  2. Parkinsonism
  3. Choreoathetosis
  4. Acute dystonia
  5. Tardive dystonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tetrabenazine

A

symptomatic treatment of hyperkinetic movement disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Involuntary, abrupt, brief and jerky movement of a body part. Often described as “lightning fast.”

A

Myoclonus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What sort of involuntary movement is a hiccup?

A

Myoclonus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Jerky movements when falling asleep

A

Hypnic jerks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lance-Adams syndrome

A

Post-hypoxic myoclonus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Asterixis is a type of:

A

Myoclonus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Unverricht-Lundborg disease,neuronal ceroid lipofuscinoses, sialidosis, and Lafora body disease are all:

A

Myoclonic epilepsies

The one that was left out: myoclonic epilepsy with ragged red fibers,

29
Q

Brief stereotyped movements, preceded by an urge, followed by a sense of relief,

A

Tic

30
Q

Tourette syndrome: Multiple motor and vocal tics beginning before age _ and lasting for at least _ months

A

Tourette syndrome: Multiple motor and vocal tics beginning before age 18 and lasting for at least 6 months

31
Q

Which movement disorder is associated with: Iron deficiency anemia, end-stage renal disease, pregnancy, peripheral neuropathy, lumbar radiculopathy, autoimmune disorders, vitamin B12, folate, or magnesium deficiencies

A

Secondary Restless Legs Syndrome

32
Q

sympatholytic drug used in the treatment of attention deficit hyperactivity disorder (ADHD), anxiety and hypertension

A

Guanfacine

33
Q

Parkinsonism

A
  1. bradykinesia
  2. rest tremor
  3. rigidity
  4. postural instability

Most sensitive: Bradykinesia is a generalized slowness of movement, and is present at onset of PD in approximately 80 percent of patients [17]. It is arguably the major cause of disability in PD and is eventually seen in almost all patients.

34
Q

Difference between Parkinsonism and Parkinson’s

A

Parkinsonism :collection of symptoms that can have many different etiologies

Parkinson disease: specific disorder that is the most common cause of parkinsonism

35
Q

Parkinsonism, gaze palsies, slow saccades, imbalance with falls, dysarthria, or truncal dystonia

A

PSP

36
Q

Parkinsonism, early dementia, fluctuating alertness, early visual hallucinations

A

Dementia with Lewy bodies

37
Q

Parkinsonism, asymmetrical stiffness, apraxia, or dysfunction of one arm, dysarthria, or dementia

A

Corticobasilar degeneration

38
Q

Parkinsonism, early autonomic dysfunction, sometimes cerebellar ataxia

A

MSA

39
Q

Prominant gait dysfunction (imbalanced, slow, feet sliding on ground), dementia, urinary incontinence, possible parkinsonism

A

NPH

40
Q

Parkinsonism of the lower body more than upper body, prominent gait disability, cognitive dysfunction (or dementia)

A

Vascular parkinsonism

41
Q

Accumulation of small or large strokes that may produce parkinsonism more centered in the lower half of the body

A

Vascular parkinsonism

42
Q

Parkinson’s disease is caused by the progressive degeneration of dopaminergic neurons within the:

A

substantia nigra

43
Q

Where is the substantia nigra?

A

Midbrain

44
Q

Aetiologyof Parkinson’s

A

Most are idiopathic

45
Q

Parkinson’s disease: Rx

A
  1. Carbidopa/levodopa (Sinemet) is still the most effective treatment. Typically: complicated by wearing off and dyskinesias.
  2. Dopamine agonists: Pramipexole, ropinirole. These have longer lasting effects than carbidopa/levodopa but usually more side effects, especially in the elderly.
  3. MAO-B inhibitors: Selegiline, rasagiline. Mild benefits but may prolong the per dose benefits of carbidopa/levodopa. Some neuroprotective effects.
  4. Catechol-O-methyltransferase (COMT) inhibitors: Entacapone + carbidopa/levodopa prolongs the effect. Tolcapone also may be used though hepatic monitoring is required.
  5. Amantadine: Weak
46
Q

Deep brain stimulation Rx of Parkinson’s disease: stimulation of the

A

subthalamic nucleus or the globus pallidus

47
Q

A motor and behavioral dysregulation syndrome with the inability to move despite full physical capability, with difficulty initiating and terminating movement. Postures become frozen or oddly positioned, and actions become contrary to intent.

A

Catatonia

48
Q

Examples of catatonia occur non-psych conditions

A
  1. Drug intoxication
  2. Tumor
  3. Encephalitis
  4. Post-liver transplant
49
Q

Forms of catatonia

A

Hypokinetic, Excited, Malignant

50
Q

Effect of benzodiazepines on catatonia

A

Improves symptoms within minutes

51
Q

Dysfunction in performing learned, skilled movements that is not due to primary neurologic dysfuntions such as weakness, sensory loss, changes in posture or tone, incoordination, or impaired attention, comprehension of the task, or cooperation

A

Apraxia

52
Q

Apraxia localization

A

parietal lobes, frontal lobes, and their subcortical connections

53
Q

Incoordination arising from dysfunction in timing, rhythm, accuracy (targeting), and smoothness of movement

A

Ataxia

54
Q

Ataxias are usually due to abnormalities in the __ or its motor and/or sensory pathways (__ ataxia)

A

usually due to abnormalities in the cerebellum or its motor and/or sensory pathways (spinocerebellar ataxia)

55
Q

Irregular timing or trajectory of targeted movements

A

Dysmetria

56
Q

Breakdown of the normal timing and sequencing of rapid alternating movements

A

Dysdiadochokinesis

57
Q

Common symptoms include imbalance, wide-based gait, falls, dysarthria, eye movement abnormalities, intention tremor, and mistargeting with the limbs (trouble pouring water, poor handwriting, knocking over objects, etc.)

A

Ataxia

ie:

  1. Stroke to cerebellum or brainstem
  2. Autoimmune: Includes celiac disease, anti-GAD syndrome, Miller Fisher syndrome
  3. Inherited disorders: Spinocerebellar ataxia, Friedreich ataxia, ataxia-telangiectasia,
  4. Metabolic/toxic: Vitamin E deficiency, hypothyroidism, chronic alcoholism
  5. Antiepileptics
  6. Infections
  7. Tumor/mass, or paraneoplastic/parainfectious
58
Q

A 38-year-old man with an unknown psychiatric history is brought to the emergency room for bizarre behavior. While waiting for the psychiatry resident to evaluate the patient, you are asked by the nurses to give him haloperidol to control his behavior, as he is placing the staff at risk. Twenty minutes later you are called to see him because the patient became stiff and unable to speak, with his eyes rolling back in his head and his jaw and neck stiffening. He has remained conscious throughout this episode. Appropriate treatment at this time would be

Phenytoin

Lorazepam

Risperidone

Diphenhydramine

A

Diphenhydramine

Dx: acute dystonic reaction from haloperidol. Patients with acute dystonic reaction maintain consciousness.

59
Q

Central vertigo: SySx

A
  1. Persistent: No change with position
  2. Directional nystagmus
  3. Severe truncal instability
  4. Negative head thrust
60
Q

Vestibular neuritis vs BPPV

A
  1. BPPV: symptoms caused by head motion.
  2. BPPV: Recurrent
  3. BPPV: symptoms last seconds
  4. VN: Single, acute episode,
  5. VN: head thrust +ve
  6. VN: prodromal viral infection
61
Q

Vertigo: causes

A
  1. BPPV
  2. VN
  3. Meniere’s
  4. Vestibular migraine
  5. Brainstem CVA
  6. Vertebrobasilar TIA
  7. Cerebellar CVA
62
Q

Vertigo: Peripheral causes

A
  1. BPPV
  2. VN
  3. Meniere’s
63
Q

Vertigo: Central causes

A
  1. Vestibular migraine
  2. Cerebellar TIA/CVA
  3. Brainstem CVA
64
Q

Vasomotor rhinitis with prominent watery rhinorrhea: Rx

A

Ipratopium nasal spray

65
Q

Vasomotor rhinitis

A

Nonallergic rhinitis (NAR) is a syndrome in which some combination of sneezing, rhinorrhea, nasal congestion, and postnasal drainage is present over time without a specific cause. The pathogenesis is not known.

Other terms for this condition include vasomotor rhinitis, idiopathic rhinitis, nonallergic-noninfectious rhinitis, and intrinsic rhinitis.

66
Q

Vasomotor Rhinitis: Rx

A
  1. mild symptoms: intranasal glucocorticoid (INGC) or an intranasal antihistamine spray
  2. Moderate-to-severe symptoms: INGCs + intranasal antihistamine
  3. ipratropium nasal spray for patients with prominent watery rhinorrhea without other symptoms
  4. NAR and prominent nasal congestion: azelastine, Pseudoephedrine PRN

Neti pot

67
Q

keratinized, desquamated epithelial collection in the middle ear or mastoid and may occur secondary to tympanic membrane perforation, but also may occur as a primary lesion.

A

Cholesteatoma

68
Q

Vertigo: recurrent episodes lasting less than a minute

A

BPPV

69
Q

Vestibular migraine vs BPPV

A
  1. Vestibular migraine symptoms last longer.
  2. VM: dx requires accompanied by aura or migraine headache

ABIM (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions