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Clinical Neurosciences > Coma and Movement Disorders > Flashcards

Coma and Movement Disorders Flashcards

1
Q

loss of consciousness

A

coma

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2
Q

consciousness relies heavily on intact

A

cerebral hemispheres and the reticular activating system

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3
Q

Describing someone who is far from alert or oriented to time and space, and exhibits other signs being confused, a state just short of frank delirium

A

obtunded

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4
Q

stupor

A

lack of critical consciousness and only responds to base stimuli

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5
Q

decerebrate posture indicates

A

midbrain injury

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6
Q

decorticate posturing indicates

A

thalamus and hemisphere injury

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7
Q

common cause for cheyne stokes

A

heart failure

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8
Q

is an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release

A

apneustic

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9
Q

characteristics of thalamus or higher injury

A

cheyne stokes respiration
small reactive pupils
decorticate posturing
brainstem reflexes are intact

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10
Q

characteristics of mid-brain injury

A

central neurogenic hyperventilation
midposition fixed pupils
decererate posturing
EOM may be impaired

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11
Q

characteristics of pons injury

A 
apneustic respiration
miotic puils 
absent EOM
absent corneal reflexes
flaccidity
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12
Q

characteristics of medulla injury

A

gasping, apenic respiration
flaccidity
absent gag reflex
blood pressure, heart rate irregularities

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13
Q

treatment

A 
ABC
IV blood draw
thamin
naloxone/romazicone
supportive
treat specific condition
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14
Q

herniation of the temporal lobe over the tentorial notch

A

uncal herniation

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15
Q

what Cranial nerve is commonly compressed by an uncal herniation

A

CN III (blown pupil, ptosis, and eye deviaion down and out)

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16
Q

glawcow coma scale eye response

A

1= eyes never open
2=eye open to pain
3= eyes open to verbal stimuli
4=eyes open spontaneously

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17
Q

glascow coma scale verbal response

A 
1= no response
2=incomprehensible sounds
3=inappropriate words
4=disoriented and converses
5= oriented
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18
Q

glaswcow coma scale motor response

A 
1=one
2- decerebrae
3-decoritcate
4-flexion with withdrawal
5=localizes pain
6-obeys
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19
Q

sustained contractions that may be rapid or reptetitive, focal or generalized or idiopthic/symptomatic

A

dystonia

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20
Q

what three medications are associated with symptomatic dystonia

A

levodopa
haloperidol
phenothiazines

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21
Q

begins focally with food inversion, facial grimacing and spasms that cause marked distortion of the body and often disappears with sleep

A

idiopathic torsion dystonia

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22
Q

how is idiopathic torsion dystonia diagnosied

A

history and physical

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23
Q

how is idiopathic torsion dystonia treated

A

diazepam, anticholinergic meds, baclofen, and carbamazepine and possible thalamotoy

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24
Q

what are the causes of torticollis syndrome

A 
hyperthyroidism
antipsychotics
ocular imbalance
cervical spine disease
fragment of idiopathic torsion dystonia
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25
Q

treatment of torticollis

A

underlying cause
botulinum toxin
surgery

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26
Q

contraction of the orbicularis oculi and other facial muscles; increased blinking, gramacing, extension of the jaw and tongue

A

blepharospasm

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27
Q

what patients are typically more affected by blepharospasm

A

females

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28
Q

when is the onset of blepharospasm

A

over age of 50

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29
Q

how is blepharospasm treated

A

botulinum toxin

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30
Q

what is the most common movement disorder

A

essential tremor

31
Q

demographics of pts with essential tremor

A

females and whites

32
Q

essential tremor is most apparent when ?

A

stress and outstretched arms

33
Q

differential diagnosis for essential tremmor

A 
hyperthryoidism
lithium
valproic acid
alcoholism
tricyclic antidepressants
low b12 level
parkinson disease
34
Q

how is essential tremor treated

A 
alcohol
beta blocker
primidone
diazepam, clonazepam, lorazepam
surgery-pacemakers
35
Q

most commonly drug induced movement disorder

A

tardive dyskinesia

36
Q

what part of the body does tardive dyskinesia involve usually

A

lower face and the orolingual buccal muscles

37
Q

chewing, tongue darting, piano playing fingers, and marching in place are indicative of

A

tardive dyskinesia

38
Q

treatment for tardive dyskinesia

A

avoid the drug complication!
eliminate cause
reserpine

39
Q

what drugs can cause drug induced parkinsonism

A

alpha methyl dopa and metoclopramide, antipychotic medications

40
Q

inner feeling of restlessness, unable to sit still and is found more often in women

A

acute akathisia

41
Q

most common reactions and often responds to injection of diphenyhydramine, benztropine and diazepam

A

acute dystonic reaction

42
Q

neurolepdrometic malignant syndrome is most common in

A

young adults

43
Q

symptoms of neuroleptic malignant syndrome

A

autonomic dysfunction, fever, rigidity, akinesia, altered mental status, acidosis and myogloburnia

44
Q

what is the treatment of neurolpetic malignant syndrome

A

drug withdrawal, bromocroptine and dantrolene

45
Q

what is a potential long term complication of neuroleptic malignant syndrome

A

renal failure

46
Q

when do you get syndeham chorea

A

ages 5-15 years of age (self limiting but may persist)

47
Q

______is a manisfestation of rheumatic fever

A

sydenham chorea

48
Q

antibodies to the subthalamic and caudate nuclei is indicative of

A

syndeham chorea

49
Q

sydenham chorea affects males or females more

A

females

50
Q

darting tongue

A

syndeham chorea

51
Q

treatment for sydenham chorea

A

sedatives
phenothiazines, haloperidol
valproic acid

52
Q

genetics of huntington chorea

A

autosomal dominant, CAG trinucleotide repead coding for huntingtin

53
Q

chromosome affected in huntington chorea

A

4p

54
Q

loss of GABA and cholinergic neurons

A

huntington chorea

55
Q

associated with atrophy of the caudate nucleus

A

huntington chorea

56
Q

loss of GABA and cholinergic neurons

A

huntington chorea

57
Q

age grp affected by huntinton chorea

A

35-40 years old

58
Q

features of huntington chorea

A

choreoathetosis, personality disorder, dementia, milkmaid grps, EOM difficulties, dancing gait, and dystonia and rigidity in advanced cases

59
Q

how do you diagnose huntington chorea

A

H and P
genetic testing
neuroimaging

60
Q

treatment of huntington chorea

A

haloperidol, phenothiazine, and tetrabenzine

61
Q

when does senile chorea begin

A

after the age of 60

62
Q

violent form of chorea

A

violent form of chorea

63
Q

lesion of contralateral subthalamic nucleus

A

hemiballism

64
Q

causes of hemiballism

A

vascular, hemorrhage, tumor or iatrogenic

65
Q

when are tics seen

A

seen between age 5-10

66
Q

simple, highly personalized, idiosyncratic mannerism

A

tics

67
Q

sniffing, clearing throat, protruding chin, blinking

A

tics

68
Q

treatment of tics

A

remove exacerbating causes, ignore it or in adults (sedatives and psychotherapy to help control tics)

69
Q

multiple tics with vocalizations

A

gilles de la tourette’s syndrome

70
Q

have anti-DNAase B antibodies

A

gilles de la tourette’s syndrome

71
Q

sexual impulses

A

gilles de la tourette’s syndrome

72
Q

is associated with OCD and ADD

A

tourettes syndrome

73
Q

how do you diagnose tourette’s

A

H and P

74
Q

treatment of tourette’s

A 
remove preciptants
clonidine
haloperidol
pimozide
naltrexone
marinol
psychotherapy
possibly a deep brain stimulator

Clinical Neurosciences (16 decks)

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