Approach to Neuro Cases 2

Question 1

What type of tremor occurs in a body part that is relaxed and completely supported against gravity?

Answer 1

Resting tremor

Question 2

What type of tremor occurs with voluntary muscle contraction and is the most common tremor?

Answer 2

Action tremor

Question 3

What type of action tremor occurs when maintaining a position against gravity?

Answer 3

Postural tremor

Question 4

What type of action tremor occurs with muscle contraction against a rigid stationary object?

Answer 4

Isometric tremor

Question 5

What type of action tremor can be produced with target directed movement such as reaching for a pen?

Answer 5

Kinetic tremor

Question 6

What is the most common pathological tremor?

Answer 6

Essential tremor

Question 7

Where area of the body are essential tremors most common in?

Answer 7

Hands and wrists (usually bilateral)

Question 8

How can caffeine, fatigue, and alcohol affect essential tremors?

Answer 8

Caffeine and fatigue exacerbate symptoms while alcohol can help (alcohol is always the cure)

Question 9

What condition can be induced by various meds blocking or depleting dopamine?

Answer 9

Parkinsonism

Question 10

70% of patients with Parkinson’s Disease have what type of tremor?

Answer 10

Resting tremor

Question 11

What type of tremor is seen more frequently in patients employed in allied health professional and those involved in litigation?

Answer 11

Psychogenic tremor

Question 12

What are some signs consistent with PD?

Answer 12

1) Decreased arm swing on the first involved side
2) Decreased facial expression
3) Shuffling gait
4) Micrographia

Question 13

What is the difference in handwriting in patients with PD vs patients with ET?

Answer 13

PD: small
ET: Large

Question 14

What condition results in loss of memory, language skills, visual perception, and problem solving to an extent that it interferes with a person’s daily life and activities?

Answer 14

Dementia

Question 15

How is dementia the 5th leading cause of death in the US even though it doesn’t kill people?

Answer 15

The patients regress and become impulsive which can lead to accidents or suicide

Question 16

What is affected by dementia when having difficulty in completing previous familiar multi-step tasks, such as preparing a meal; no longer wanting to participate in activities of the home; social outing are less enjoyable; hard to complete tasks because of easy distractibility?

Answer 16

Executive function

Question 17

What is affected by dementia when having difficulty in using familiar technology, tools, or kitchen appliances; getting lost in familiar environments?

Answer 17

Perceptual motor

Question 18

The lower the score on a mini-mental state examination (MMSE) means?

Answer 18

The more significant the dementia

Question 19

When filling out a differential diagnosis dealing with social cognition, what should be on there?

Answer 19

Delirium

Question 20

What relation do hypothyroidism, vitamin deficiencies, tumors, normal pressure hydrocephalus, depression, and heart failure have to dementia?

Answer 20

They are all reversible causes of dementia