Yocom 2

Question 1

What are hyperkinetic movements?

Answer 1

Myoclonus (fast)
Dystonia (sustained)
Chroea (twisting)
Tics (repetitive) 
Ballism (failing)
Athetosis (slow writhing)
Tremor (oscillation)

Question 2

What are hypokinetic movements?

Answer 2

Akinesia (power loss)

Bradykinesia (slow)

Question 3

What 3 features are unique to dystonia?

Answer 3

Task specificity, Geste antagoniste, state function

Question 4

What is task-specific dystonia often confused for?

Answer 4

Focal dystonia

Question 5

What are the tree key factors to diagnosing dystonia?

Answer 5

Age of onset, distribution in body, other neurological disturbances

Question 6

When is the normal age of onset for dystonia?

Answer 6

Before 26

Question 7

What is primary dystonia?

Answer 7

Dystonia is isolated w/ no other symptoms (neurological)

Question 8

What is secondary dystonia?

Answer 8

Due to a drug/toxin

Question 9

What is the treatment of choice for focal dystonia?

Answer 9

Botox injection

Question 10

What are the drugs used for dystonia (ABC)?

Answer 10

Artane, Baclofen, Clonazepam

Question 11

What is a kinetic tremor?

Answer 11

Tremor with movement

Question 12

Which is the most common tremor seen in adults?

Answer 12

Essential Tremor

Question 13

What exacerbates the essential tremor?

Answer 13

Stress, exercise, fatigue, caffeine, meds

Question 14

What makes the essential tremor better?

Answer 14

Relaxation and alcohol

Question 15

What is the first line treatment for essential tremor?

Answer 15

Primidone or propanolol

Question 16

What is the most common primary tic disorder?

Answer 16

Tourette Syndrome

Question 17

What are some secondary cause of tics?

Answer 17

Neurodevelopmental, acute brain lesions, post-infection, neurodegenerative, meds

Question 18

What is the treatment for tourettes?

Answer 18

Alpha 2 agonists, clonidine and guanfacine

Question 19

What types of motion and clinical features would be seen in Huntington’s?

Answer 19

Chorae, bradykinesia, dystonia, irritability, mania, depression, lack of self-control, dysphagia, strained loud voice, hostile outbursts

Question 20

What are some early signs of huntington’s cognitive decline?

Answer 20

Forgetfulness, difficulty maintaining attention/focus and multitasking

Question 21

What are the genetic features of huntington’s?

Answer 21

Autosomal dominant, CAG repeat

Question 22

What is Wilsons disease (hepatolenticular degeneration)?

Answer 22

Mutations resulting in elevated levels of copper in the body

Question 23

What are the principle problems in Wilson’s disease?

Answer 23

Reduced copper excretion due to mutated ATP7B

Impairs formation of ceruoloplasmin

Question 24

What occurs if there is a build up of copper?

Answer 24

It’s toxic so oxidative damage occurs; screws up liver and basal ganglia, causes cerebral atrophy

Question 25

What are the signs and symptoms of Wilsons?

Answer 25

Progressive neurodegenerative that starts 11-25 y/o Liver signs proceed neurological ones Mood changes, depression, psychosis

Question 26

What are the physical neurological signs of Wilsons?

Answer 26

Dystonia and tremor (wing beat), rigidity, Kayser-Fleisher ring

Question 27

What MRI sign would you see in Wilsons?

Answer 27

Giant panda sign

Question 28

What is the treatment for Wilsons?

Answer 28

Initial phase: Pencillamine Maintenance phase: Zinc acetate (prevents Cu GI absorption) Liver transplant

Question 29

What are the cardinal features of Parkinson's?

Answer 29

Tremor at rest/postural, bradykinesia, rigidity

Question 30

What proteins can be linked to Parkinson's?

Answer 30

a-synnuclein, parkin, UCH-L1

Question 31

What is the first step to diagnose Parkinson's?

Answer 31

Bradykinesia + Rigity OR Tremor at rest OR Postural instability

Question 32

What is step 2 to diagnose Parkinson's?

Answer 32

Exclusion of other things that may show similar signs

Question 33

What is step 3 to diagnose Parkinson's?

Answer 33

Support features | Unilateral onset, rest tremor, levodopa responsiveness

Question 34

What dec the risk of getting Parkinson's?

Answer 34

Caffeine, cigarettes

Question 35

What are some drug therapies to use for Parkinson's?

Answer 35

Monoamines oxidase B inhibitors (Selegiline, Rasagiline) with levodopa Amantadine

Question 36

Who cannot take anticholinergic drugs for Parkinson's?

Answer 36

Elderly (over 65)

Question 37

What are the surgical procedures done to treat Parkinson's?

Answer 37

``` Deep brain stimulation, creation of lesions Thalamic surgeries (tremor), Pallidal/subthalamic (global effect) ```