Unit 3: Movement Disorders Flashcards Preview

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Flashcards in Unit 3: Movement Disorders Deck (69):
1

L1: "Ka" speech evaluates CN __.

X

2

L1: "La" speech evaluates CN __.

XII

3

L1: "Pa" speech evaluates CN __.

VII

4

L1: Which Parkinson's therapeutic agent? Blocks decarboxylase, does not cross blood-brain barrier

Carbidopa

5

L1: Which pathologic pattern? Brief, intermittent movements or sounds, varying in intensity and repeated at irregular intervals

Tics

6

L1: Which pathologic pattern? Chorea-athetosis, dementia, and psychiatric illness

Huntington Disease

7

L1: Which pathologic pattern? Gross atrophy of caudate nucleus due to loss of medium spiny neurons

Huntington Disease

8

L1: Which pathologic pattern? Hereditary ataxia with limb ataxia, dysarthria, loss of distal position/vibration sense, areflexia, lower extremity UMN signs

Friedreich's Ataxia

9

L1: Which pathologic pattern? Motor and vocal tics, poor impulse control, associated with OCD and ADHD

Tourette Syndrome

10

L1: Which pathologic pattern? Motor seizures, psychosis and personality disorders from temporal lobe involvement

Complex seizures

11

L1: Which pathologic pattern? Resting tremor, typically non-disabling and unilateral, rigidity, bradykinesia

Parkinson Disease

12

L2: Neuroleptic dopamine receptor antagonist used in Huntington disease

Haloperidol

13

L2: Positive findings (intention tremor) in the finger-nose-finger test or heel-shin test indicate ______.

dysmetria

14

L2: Pronator drift positivity indicates ________.

UMN syndrome: ipsilateral cerebellum/contralateral cortex

15

L2: What is the histologic pattern associated with Huntington Disease?

Caudate atrophy/gliosis

16

L2: What is the histologic pattern associated with Parkinson's Disease?

Lewy Bodies and Lewy neurites in neuron processes

17

L2: What is the histologic pattern associated with Wilson's disease?

Copper deposits in the putamen and globus pallidus

18

L2: Which gait disorder? Dragging toes, tightness of hip flexors that can result in midline crossing/scissored gait

Diplegic gait

19

L2: Which gait disorder? Foot drop, attempt to lift foot high enough such that it does not drag

Neuropathic gait

20

L2: Which gait disorder? Irregular jerky involuntary movements in all extremities, dancing/prancing

Choreiform gait

21

L2: Which gait disorder? Loss of proprioceptive input from feet, patient slams foot into ground to know when it contacts the ground

Sensory gait

22

L2: Which gait disorder? Patient holds flexed/adducted/internally rotated arm to side and circumducts foot

Hemiparetic gait

23

L2: Which gait disorder? Rigidity, bradykinesia, slow little steps, difficulty initiating steps

Bradykinetic/Parkinsonian gait

24

L2: Which gait disorder? Seen in biventricular lesions like cerebral palsy

Diplegic gait

25

L2: Which gait disorder? Spasticity in lower extremity with abnormally narrow base

Diplegic gait

26

L2: Which gait disorder? Staggering clumsy movements with wide-based gait, inability to walk heel to toe or in a straight line

Ataxic gait

27

L2: Which gait disorder? Stooped posture with neck forward and flexion at knees

Bradykinetic/Parkinsonian gait

28

L2: Which gait disorder? Unilateral or bilateral weakness that leads to drop of pelvis and waddling if bilateral

Myopathic gait

29

L2: Which gait disorder? Unilateral UMN injury resulting in plantar flexion and leg extension on affected side

Hemiparetic gait

30

L2: Which movement or psychiatric disorder can be elicited from the following treatment? Anti-psychotics

Parkinsonism

31

L2: Which Parkinson's therapeutic agent? Decreases cholinergic inhibitory interneuron activity in the striatum

Anticholinergic agents

32

L2: Which Parkinson's therapeutic agent? Increases endogenous release of dopamine, may work as glutamate receptor antagonist

Amantadine

33

L2: Which Parkinson's therapeutic agent? Not as effective as L-DOPA, side effects parasympathetic block peripherally

Anticholinergic agents

34

L2: Which Parkinson's therapeutic agent? Prevents breakdown of dopamine, can cause dangerous episodes of hypertension following NOR release

Monoamine oxidase inhibitors

35

L2: Which Parkinson's therapeutic agent? Prevents breakdown of L-DOPA by COMT

Catechol-o-methyltransferase inhibitors

36

L2: Which Parkinson's therapeutic agent? Used to smoothen the short half-life of L-DOPA and decrease dyskinesia

Dopamine Receptor Agonists

37

L2: Which pathologic pattern? Active opposition of any passive movement despite instruction to relax

Gegenhalten/paratonia

38

L2: Which pathologic pattern? Bilateral and disabling tremor (often postural) most commonly affecting the hands

Essential Tremor

39

L2: Which pathologic pattern? Co-contration of muscle agonists and antagonists, twisting abnormal postures resulting from sustained muscle contractions

Dystonia

40

L2: Which pathologic pattern? Exaggerated startle

hyperekplexia

41

L2: Which pathologic pattern? Glial alpha-synuclein inclusions

Multiple Systems Atrophy

42

L2: Which pathologic pattern? HANDS Tremor signs

Cerebellar extra-pyramidal signs

43

L2: Which pathologic pattern? Irregular, brief, dancing-like jerky movements

Chorea

44

L2: Which pathologic pattern? Large amplitude proximal flinging movements

ballism

45

L2: Which pathologic pattern? Localized quivering of few muscle bundles

myokymia

46

L2: Which pathologic pattern? Neuronal alpha-synuclein inclusions

Parkinson Disease, Diffuse Lewy Body Disease

47

L2: Which pathologic pattern? Repeated or ritualistic movement or utterance

stereotypy

48

L2: Which pathologic pattern? Repetitive involuntary, slow sinuous writhing movements

Chorea-athetosis

49

L2: Which pathologic pattern? Sudden brief shock-like movements

myoclonus

50

L2: Which pathologic pattern? Tremor, hypokinetic signs, hyperkinetic signs, dystonia

Basal ganglia extra-pyramidal signs

51

L2: Which pathologic pattern? Unpleasant sensation of inner restlessness (inability to remain motionless)

akathisia

52

L2: Which tests are used to evaluate for dysmetria?

Finger-nose-finger, Heel-shin

53

L2: Which pathologic pattern? Wing-beating tremor (basal ganglia degeneration), depression, exhibitionism, psychosis

Wilson Disease

54

L3: Name the three components of Multiple System Atrophy

Striatonigral degeneration, olivopontocerebellar atrophy, intermediolateral column degeneration

55

L3: Treatment for Essential Tremor (2)

Primidone, Propranolol

56

L3: Treatment for Tourette Syndrome or Huntington Disease (2)

Tetrabenazine, neuroleptics (dopamine receptor antagonists)

57

L3: What is the histologic pattern associated with ataxias?

atrophy of cerebellar folia, loss of Purkinje cells

58

L3: What is the histologic pattern associated with Corticobasal Degeneration?

Tau-immunoreactive inclusions, cerebral cortical atrophy

59

L3: What is the histologic pattern associated with Diffuse Lewy Body Disease?

Lewy bodies diffusely distributed, neuritic plaques and neurofibrillary tangles

60

L3: What is the histologic pattern associated with Multiple Systems Atrophy?

Glial alpha-synuclein inclusions distributed broadly

61

L3: What is the histologic pattern associated with Progressive Supranuclear Palsy?

Neurofibrillary tangles in neurons, tau-immunoreactive glia (especially in the basal ganglia)

62

L3: Which movement or psychiatric disorder can be elicited from the following treatment? L-DOPA/Parkinson's therapeutics

Hallucinations, delusions, erratic behaviors

63

L3: Which Parkinson's therapeutic agent? Anticholinergic agents (3)

Diphenhydramine, Trihexyphenidyl, benztropine

64

L3: Which Parkinson's therapeutic agent? COMT inhibitors (2)

tolcapone, entacapone

65

L3: Which Parkinson's therapeutic agent? Monoamine oxidase inhibitors (2)

rasagiline, selegiline

66

L3: Which pathologic pattern? Classified as tauopathies (3)

Dementing diseases, Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD)

67

L3: Which pathologic pattern? Synucleinopathies involving Lewy bodies (3)

Parkinson Disease, Diffuse Lewy Body Disease, Multiple Systems Atrophy

68

L4: Which Parkinson's therapeutic agent? Dopamine Receptor Agonists (5)

Pergolide, cabergoline, ropinerole, pramipexole, bromocriptine

69

L4: Which pathologic pattern? Disorders presenting with parkinsonism and substantia nigra disorder (5)

Parkinson Disease, Multiple System Atrophy, Progressive supranuclear palsy (PSP), Pick Disease, Corticobasal degeneration