CLMD Movement Disorders, Dementia

Question 1

Cardinal features of idiopathic parkinson’s disease

Answer 1

Tremor
Rigidity
Bradykinesia

[other features = hypophonia, hypomimia, decreased eye blink, myerson’s sign, postural instability]

Question 2

Condition characterized by:

Bradykinesia and rigidity

Loss of voluntary control of eye movements (especially vertical gaze)

Answer 2

PSP

Question 3

Condition characterized by:

Both cortical and basal ganglionic dysfunction

Bradykinesia and rigidity

Possible cortical sensory loss, apraxia, myoclonus, or aphasia

Answer 3

CBD

Question 4

Condition characterized by:

Bradykinesia and rigidity

Pronounced autonomic dysfunction

Answer 4

MSA

Question 5

Autosomal dominant disease with gradual onset and progression of chorea and dementia caused by inherited trinucleotide repeat

Answer 5

Huntington’s disease

Question 6

Occurs mainly in children and adolescents as a complication of a previous infection with group A strep, may be a form of arteritis

Answer 6

Sydenham’s chorea

Question 7

Treatment of choice for focal dystonia that is not often used in idiopathic torsion dystonia

Answer 7

Botox

Question 8

AR disorder of copper metabolism that produces neuro and hepatic dysfunction; usually presents in childhood or young adult life and produces both bradykinetic and hyperkinetic features

Answer 8

Wilson’s disease

Question 9

Condition that often presents when patient notes memory difficulties but has normal cognitive function and normal ADLs

Answer 9

Mild cognitive impairment

[note that this is probably a precursor to alzheimers as these pts are 5x more likely to develop it; tx with AChEI meds to slow progression]

Question 10

Criteria for vascular dementia

Answer 10

Cerebrovascular disease defined by presence of focal signs on neuro exam, such as hemiparesis, lower facial weakness, babinksi sign, sensory deficit, hemianopia, consistent with stroke AND…

Evidence of relevant cerebrovascular disease at brain imaging including multiple large-vessel infarcts or single strategically situated infarct, as well as multiple basal ganglia and white matter lesions and white matter lacunes

Question 11

A relation between cognitive problems and vascular events may be inferred by what patterns of dementia?

Answer 11

Onset of dementia within 3 months after recognized stroke

Abrupt deterioration in cognitive function

Fluctuating, stepwise progression of cognitive deficits

Question 12

Tetrad of symptoms associated with diffuse lewy body disease

Answer 12

Dementia
Parkinsonian symptoms (w/o tremor)
Prominent psychotic symptoms (visual hallucinations)
Extreme sensitivity to anti-psychotic agents

Question 13

Up to 81% of patients with diffuse lewy body disease have what disease feature?

Answer 13

Unexplained periods of markedly increased confusion that last days-weeks and closely mimic delirium

Question 14

When do parkinson patients exhibit hallucinations?

Answer 14

Only in response to antiparkinsonian drugs

Question 15

_____ _____ includes several forms of dementia characterized by a slowly progressive deterioration of social skills and changes in personality along with impairment of intellect, memory and language; EEG helps rule out psychiatric causes

Answer 15

Frontotemporal degeneration

Question 16

Triad of symptoms associated with normal pressure hydrocephalus

Answer 16

Dementia
Gait disturbance
Urinary incontinence

Question 17

Normal pressure hydrocephalus is potentially reversible with ventriculoperitoneal shunting. What symptom is most likely to be reversed with this treatment?

Answer 17

Gait disturbance