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NMSP Exam 2 > [CLMD] Movement Disorders [Hon] > Flashcards

[CLMD] Movement Disorders [Hon] Flashcards

1
Q

What are the two categories of movement disorders?

A

Bradykinetic

Hyperkinetic

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2
Q

What is the most common form of bradykinetic disorder?

List examples that embody this form

A

Parkinsonism

(which encompasses many disoders)

  • Idiopathic PD
  • Postencephalitic
  • Toxin-induced (Carbon monoxide)
  • Drug-induced
  • MPTP (synthetic meperidine)
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3
Q

What is the definition of idiopathic parkinson’s disease?

A

Depletion of dopamine in the nigrostriatal system

disrupting the balance of dopamine and acetylcholine

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4
Q

What are the 3 cardinal features of parkinson’s

A

Tremor

Rigidity

Bradykinesia

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5
Q

What does a parkinson tremor look like?

A

“Pill rolling” quality

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6
Q

What is rigidity?

A

Increased resistance to passive movement, “cogwheel” quality

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7
Q

What is bradykinesia?

A

Slowness of movement

Difficulty initiating movement

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8
Q

What are some other features of parkinson’s disease?

(just be able to recognize)

A
  • Postural instability
  • Hypophonia (quiet voice)
  • Hypomimia (masked facies)
  • Decreased frequency of eye blink

-Myerson’s sign

-Dementia

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9
Q

What is myerson’s sign?

A

Repetitive tapping on the forehead leads to sustained blink response

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10
Q

What is the unique feature of this akinetic rigid syndrome:

Progressive supranuclear palsy (PSP)

A

Loss of voluntary control of eye movement

(especially vertical gaze)

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11
Q

What is the unique feature of this akinetic rigid syndrome:

Multiple systems atrophy - MSA

aka?

A

Pronounced autonomic dysfunction

Aka = Shy-drager syndrome

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12
Q

What is the unique feature of this akinetic rigid syndrome:

Cortical basal (ganglionic) degeneration (CBD)

A

Both cortical and basal ganglionic dysfunction

Bradykinesia and rigidity

Cortical sensory loss: apraxia, myoclonus, aphasia

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13
Q

What is the unique feature of this akinetic rigid syndrome:

Lewy body disease

A

Visual hallucinations

(children, little animals)

Not always disruptive to the patient

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14
Q

As a general rule, _____________ medications have little if any effect on the “other” akinetic rigid syndromes (progressive supranuclear palsy, multiple systems atrophy, cortical basal degeneration, lewy body)

A

As a general rule, ANTI-PARKINSONIAN medications have little if any effect on the “other” akinetic rigid syndromes (progressive supranuclear palsy, multiple systems atrophy, cortical basal degeneration, lewy body)

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15
Q

What are examples of anti-parkinsonian pharmacologic interventions?

A

Dopmaine agonists

Levodopa

COMT inhibitors

Anticholinergics

MAO-B inhibitor

Amantadine

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16
Q

What is a new surgical technique used for parkinson therapy?

A

Deep brain stimulation

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17
Q

Hyperkinetic movements

Define: Chorea

A

Irregular, brief, “dancelike” movements

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18
Q

Hyperkinetic movements

Define: Athetosis

A

Writhing, sinous movements

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19
Q

Hyperkinetic movements

Define: Dystonia

A

Sustained muscles contract that produce twisting and repetitive movements and abnormal postures

20
Q

Hyperkinetic movements

Define: Ballism

A

Large amplitude, flinging movement

21
Q

Hyperkinetic movements

Define: Tic

A

Brief, rapid, repetitive and seemingly purposeless stereotyped action

22
Q

Define huntingtons disease

A

Gradual onset and progression of chorea and dementia caused by inherited CAG repeat gene defect on chromosome 4

23
Q

When do symptoms typically begin with huntingtons disease?

24
Q

What are typically the FIRST symptoms that arise early in huntingtons disease?

25
What is the name of the chorea related to "**children and adolescents w/ previous infection with Group A hemolytic streptococcus**"
Sydenham's chorea
26
What is the treatment for **sydenham's chorea?**
Bedrest and antibiotics
27
What is the key to identifying **sydenham's chorea?**
Characterized by **unilateral** choreiform movements
28
About to blow the minds of sketchy people: Remember this...
The "S" in the Jones criteria for **group A strep** infections stands for **Sydenham chorea** Holy shit holy shit
29
What is **idiopathic torsion dystonia** characterized by?
Dystonic movements and postures **without other signs**
30
What are 3 common clinical findings with **idiopathic torsion dystonia?**
Torticollis Blepharospasm Oromandibular dystonia
31
What is **blepharospasm?**
Spontaneous involuntary forced closure of eyelids
32
What is **oromandibular dystonia?**
Spasms of muscles around mouth
33
What are examples of treatments to use for **idiopathic torsion dystonia?**
Low dose levodopa Anticholinergics Benzos Neuroleptic drugs Baclofen Carbamazepine
34
What is **focal torsion dystonia?**
Dystonia confined to **FOCAL** area
35
What is a commonly associated type of cramp with **focal torsion dystonia?**
Writer's cramp
36
What is the best medication for **focal torsion dystonia?**
BOTOX
37
TEST QUESTION Define **Wilson's disease**
Autosomal recessive disorder of **copper metabolism** that produces **neurologic** and **hepatic** dysfunction
38
What is INCREDIBLY unique about the clinical manifestation of **wilson's disease?**
Both **bradykinetic** AND **hyperkinetic**
39
How id **wilson's disease** diagnosed?
Increased amounts of **copper** excretion in 24 h urine collection **Kayser-Fleisher** ring on exam Decreased **serum ceruloplasmin level**
40
What is the definition of **tourette's?**
Chronic multiple **motor** and **vocal tics** with onset before the age of 21
41
What do the following terms associated with tourettes syndrome mean? Coprolalia= Echolalia= Echoproxia= Palillalia=
Coprolalia= Vulgar or obscene speech Echolalia= Parroting speech of others Echoproxia= Imitation of others' movements Palillalia= Repetition of words or phrases
42
What is the classic pharmacologic treatment for **tourettes?**
Clonidine
43
Essential tremor aka?
Benign familial tremor
44
What is the clinical presentation of **essential tremor?**
Postural or **_kinetic tremor_** of both hands and may involve the **head** or **voice**
45
What is the progression of **essential tremor?**
Progresses slowly over years to decades
46
What is something that can decrease a **essential tremor**?
EtOH
47
What are some pharmacologic treatments for **essential tremor?**
Beta blockers Primidone Benzodiazepines Topiramate Deep brain stimulation

NMSP Exam 2 (16 decks)

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