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Question 1

What two classes of drugs are used to treat Alzheimer’s disease?

Answer 1

Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine and tacrine). Works best for mild to moderate dementia
NMDA receptor antagonists (memantine) blocks the excitotoxic effects of glutamate. Works best for moderate to severe dementia

Question 2

What is the pathogenesis of ALS?

Answer 2

The etiology is unknown but this disorder is characterized by the presence of both UMN and LMN lesions. LMN lesions are in the anterior horn motor neurons in the spinal cord. UMN lesions are in the lateral corticospinal tracts.

Question 3

What are the differences in UMN and LMN signs?

Answer 3

UMN - hyperreflexivity, increased tone, muscle spasm, positive Babinski sign
LMN - weakness, muscle atrophy, muscle fasciculations, negative Babinski sign

Question 4

Why does central cord syndrome lead to upper extremity weakness but not lower extremity weakness?

Answer 4

Because the most medial portions of the corticospinal tracts supply the muscles of the upper extremities and the most lateral portions of the corticospinal tracts supply the muscles of the lower extremities

Question 5

Which medications to treat open angle glaucoma work by increasing aqueous humor outflow? by decreasing aqueous humor production?

Answer 5

increasing outflow - prostaglandins, alpha adrenergic agonists, cholinergic agonists
decreasing production - carbonic anhydrase inhibitors, beta blockers and alpha adrenergic agonists

Question 6

What are the side effects of the prostaglandins used to treat open angle glaucoma?

Answer 6

latanoprost can cause conjunctival hyperemia, brown discoloration of iris, lengthening and darkening of eyelashes

Question 7

What condition presents with ipsilateral Horner’s syndrome + ipsilateral nystagmus + ipsilateral limb ataxia? What is another neurological characteristic of this condition?

Answer 7

Wallenberg’s syndrome which is due to a stroke in the posterior inferior cerebellar artery, knocking out the lateral medulla
Wallenberg’s syndrome is also characterized by impaired pain and temp sensation in the ipsilateral face and contralateral body

Question 8

Rigidity and spasticity are two forms of hypertonia. How are they different?

Answer 8

Rigidity is due to damage to the basal ganglia; “cog-wheel” resistance
Spasticity is due to damage to upper motor neurons, motor cortex; “clasp knife” resistance