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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?

A

30-50

24
Q

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

A

Psychosis

25
Q

What is the name of the chorea related to “children and adolescents w/ previous infection with Group A hemolytic streptococcus”

A

Sydenham’s chorea

26
Q

What is the treatment for sydenham’s chorea?

A

Bedrest and antibiotics

27
Q

What is the key to identifying sydenham’s chorea?

A

Characterized by unilateral choreiform movements

28
Q

About to blow the minds of sketchy people:

Remember this…

A

The “S” in the Jones criteria for group A strep infections stands for Sydenham chorea

Holy shit holy shit

29
Q

What is idiopathic torsion dystonia characterized by?

A

Dystonic movements and postures without other signs

30
Q

What are 3 common clinical findings with idiopathic torsion dystonia?

A

Torticollis

Blepharospasm

Oromandibular dystonia

31
Q

What is blepharospasm?

A

Spontaneous involuntary forced closure of eyelids

32
Q

What is oromandibular dystonia?

A

Spasms of muscles around mouth

33
Q

What are examples of treatments to use for idiopathic torsion dystonia?

A

Low dose levodopa

Anticholinergics

Benzos

Neuroleptic drugs

Baclofen

Carbamazepine

34
Q

What is focal torsion dystonia?

A

Dystonia confined to FOCAL area

35
Q

What is a commonly associated type of cramp with focal torsion dystonia?

A

Writer’s cramp

36
Q

What is the best medication for focal torsion dystonia?

A

BOTOX

37
Q

TEST QUESTION

Define Wilson’s disease

A

Autosomal recessive disorder of copper metabolism that produces neurologic and hepatic dysfunction

38
Q

What is INCREDIBLY unique about the clinical manifestation of wilson’s disease?

A

Both bradykinetic AND hyperkinetic

39
Q

How id wilson’s disease diagnosed?

A

Increased amounts of copper excretion in 24 h urine collection

Kayser-Fleisher ring on exam

Decreased serum ceruloplasmin level

40
Q

What is the definition of tourette’s?

A

Chronic multiple motor and vocal tics with onset before the age of 21

41
Q

What do the following terms associated with tourettes syndrome mean?

Coprolalia=

Echolalia=

Echoproxia=

Palillalia=

A

Coprolalia= Vulgar or obscene speech

Echolalia= Parroting speech of others

Echoproxia= Imitation of others’ movements

Palillalia= Repetition of words or phrases

42
Q

What is the classic pharmacologic treatment for tourettes?

A

Clonidine

43
Q

Essential tremor

aka?

A

Benign familial tremor

44
Q

What is the clinical presentation of essential tremor?

A

Postural or kinetic tremor of both hands and may involve the head or voice

45
Q

What is the progression of essential tremor?

A

Progresses slowly over years to decades

46
Q

What is something that can decrease a essential tremor?

A

EtOH

47
Q

What are some pharmacologic treatments for essential tremor?

A

Beta blockers

Primidone

Benzodiazepines

Topiramate

Deep brain stimulation

NMSP Exam 2 (16 decks)

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