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cns > cerebellum, parkinson, alzheimers > Flashcards

cerebellum, parkinson, alzheimers Flashcards

1
Q

what disease is progressive depletion of dopamine secreting cells

A

parkinsons

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2
Q

accumulation of what in parkinsons causes lewy bodies ?

A

a-synuclein

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3
Q

70 yr old male presents with tremor describes as pill rolling at rest better w movement worse when anxious affected unilateral upper limb then ipsilateral lower limb then bilateral

A

parkinsons

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4
Q

how can u describe the rigidity of parkinsons

A

lead pipe or cogwheel when combined w tremor

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5
Q

what disease presents with shuffling gait stooped posture with poor arm swing

A

parkinsons

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6
Q

parkinson patient most likely all develop

A

dementia

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7
Q

commonest cause of death in parkinsons

A

bronchopneumonia

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8
Q

tx of parkinsons

A

levodopa or carbidopa

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9
Q

secondary causes of hypokinetic movement disorders

A

drug induced: dopamine receptor blocker
post encephalitic
wilsons disease

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10
Q

what type of disorder is autoimmune HLA-DR2

A

multiple sclerosis

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11
Q

what factors cause multiple sclerosis

A

EBV
HHV6
smoking
low vit D
sunlight exposure

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12
Q

what is the most common pattern in multiple sclerosis progression

A

relapsing-remitting

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13
Q

multiple sclerosis is combination of two types of hypersensitivity reactions

A

type 4( oligodendrocyte dysfunction)
type 2 ( antibody and complement mediated damage)

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14
Q

type 4 pathology in ms

A

oligodendrocyte dystrophy , oligo r the ones that produce myelin so if no myelin then degeneration occurs

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15
Q

type 2 pathology in ms explain

A

antibody and complement activated , complement deposit in myelin sheath lead to inflam and destruction

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16
Q

common sites for plaques to deposit in ms

A

optic nerve
perivent white matter
bs and cerebellar connections
cervical sc

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17
Q

two signs found in ms patients

A

Lhermitte sign: tingling electric shock like sensation that radiates to the arm and back or in legs on flexion of pt neck

uhthoffs sign: inc symptoms w hot weather and bath

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18
Q

what do u see on mri of ms pt

A

periventricular lesions

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19
Q

in csf of ms pt you see what

A

igG oliglonal bands
high protein
and cd4 T cells

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20
Q

cerebellar disease affects contralateral side
(true or false)

A

false. ipsilateral side bcz of decussation

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21
Q

signs of cerebellar disease or spinocerebellar ataxia

A

DANISH
disdiadokinesa
ataxia
nystagmus
intention tremor
slurred speech
hypotonia

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22
Q

pancerebellar syndrome causes bilateral signs what are differentials

A

toxins
metabolic
infections
autoimmune

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23
Q

what happens if (vestibulocerebellum) flocculonodular lobe is affected

A

problems in balance and eye movements
(truncal ataxia, vertigo, nystagmus, vestibular ocular reflex)

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24
Q

what is the function of spinocerebellum (vermis and intermediate hemisphere)

A

proprioception

regulate muscle tone and coordinate limb movements

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25
what happens if vermis or intermediate zone are affected
gait ataxia dysmetria disdadokinesia
26
how can u differ if person has lesion in dorsal column or vermis / intermediate zone ?
by romberg sign , if cerebellar pt will sway and lose balance with eyes open
27
what happens if rostral (anterior) vermis is affected ?
signs: gait and trunk ataxia differentials: alcoholism, thiamine deficient
28
caudal (posterior) vermis function?
coordinates balance and eye movements postural stability during voluntary movements associated w vestibular system
29
if caudal posterior vermis affected what are the signs ?
nystagmus vertigo balance disturbance truncal ataxia
30
differentials of caudal vermis is
medulloblastoma - often in posterior vermis in children
31
drug induced cerebellar degeneration from what drugs
anti-epileptics (phenytoin)
32
what is paraneoplastic cerebellar degen ?
autoimmune reaction where immune system in response to a tumor mistakenly attack the cerebellum w
33
what do u see in serum csf in paraneoplastic cerebellum degeneration?
paraneoplastic antibodies
34
what is the trinucleotide repeat disorder in friedreich's ataxia?
>/= 200 GAA repeats
35
friedriech ataxia mutation in what gene
FXN gene on chrom 9 encodes protein frataxin
36
pathophysiology of FA
frataxin defeciency impair mitochondrial function causing oxidative stress and energy production deficit in cns cardio pancreas
37
to confirm multiple sclerosis what do u see in fundoscopy
optic disc swelling in one eye and in advanced stage optic atrophy
38
if color test is done w pts with ms what will they see
red desaturation
39
what is a pnemonic to remember features of idiopathic intracranial hemorrhage( pseudotumor cerebri)
FATHEAD female abnormal wt tinnutis headache elevated icp absence of tumor double vision (CN6)
40
first line tx of multiple sclerosis
steroids
41
define increased intracranial pressure
sustained elevation in pressure above 20 (normal btwn 8-18)
42
what is progressive decline in memory and at least one other cognitive area such as attention, orientation, judgment
dementia
43
what are causes of dementia or risk factors
age (elderly) gender female down syndrome Apo E4
44
reversible causes of dementia
hypoglycemia hypothyroidism vit b12 deficiency normal pressure hydrocephalus
45
what is acute disorder of attention and global cognition and dusturbance in consciousness that develops rapidly
delerium
46
how can u differ between dementia and delirium
alertness fluctuates in delirium whereas alertness is normal in dementia
47
what are differentials of dementia
alzheimers disease vascular disease (repeated strokes--> cognitive decline) drugs, depression, delirium ethanol (korsakoff wernicke encephalopathy) endocrine, ears, eye, environ amnesia, autoimmune, apnea
48
causes of delerium include
D dementia E electrolyte disorder L lung, liver, heart, kidney, brain I infection (UTI) R Rx drugs I injury, pain, stress U unfamiliar environment M metabolic
49
what disease includes extracellular amyloid plaques and intracellular tangles of hyperphosphoralated tau protein (neurofibrillary tangles )
alzheimers disease
50
what is the pathology in alzhemiers what accumulates?
defective processing of APP( precursor of AB) result in accumulation of AB42 with increase b-secretase activity
51
what may cause death in alzheimers disease?
aspiration pneumonia and infections
52
what is an intermediate zone btwn normal and AD w presence of new memory complains with lack of impairment in other cog functions
mild cognitive impairment
53
what neurodegenerative disease is associated with parkinsons
lewy body dementia
54
what type of dementia is due to stroke
vascular dementia
55
what do u see in vascular dementia
multi-infarct, strokes, hemorrhages (cystic spaces seen on autopsy)
56
vascular dementia shows signs of upper motor neuron or lower
UMNL
57
what type of dementia shows early change in personality, loss of empathy, and socially inapropriate behavior?
frontotemporal dementia (pick's disease)
58
what kind of dementia that drugs of AD dont help with
picks disease (frontotemporal dementia )
59
what is the early onset or hallmark of lewy body dementia
visual hallucinations
60
what is an autosomal dominant disease characterized by progressive chorea, personality change, dementia, death
huntingtons disease
61
what is the cause of huntington disease depletion of what hormones ?
Gaba (inhibitory neuron) and acetylcholine sparing dopamine
62
how is dopamine spared in huntington?
the main part degenerated in HD is striatum which includes gaba and ach and dopamine remain intact and elevated bcz of loss of ihibitory gaba input
63
what type of chorea occurs due to post-strep in children and history of enlarged tonsils followed by fidgety movements
sydenhams chorea
64
what are sudden electric jerk like movements of a part of the body or whole body
myoclonus
65
sudden vigorous forceful movements usually involving a whole limb due to stroke in subthalamic nucleus
ballismus

cns (9 decks)

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