dementias and movement disorders

Question 1

Binswanger’s disease - type of dementia

Answer 1

Small vessel vascular dementia

Question 2

Binswanger’s disease symptoms

Answer 2

4 Ds - Dementia, dysexecutive synd, delay (slow), depletion (apathy and amotivation)

Question 3

Binswanger’s disease MRI

Answer 3

periventricular white matter abnormalities

Question 4

Vascular dementia

4 Ds - Dementia, dysexecutive synd, delay (slow), depletion (apathy and amotivation)

Answer 4

Binswanger’s disease

Question 5

Tauopathies

Answer 5

Alzheimer, FTD, CBD, PSP

Question 6

alpha-synuclinopathies

Answer 6

Parkinson’s, MSA, lewy body dementia

Question 7

Alzheimer’s pathology

Answer 7

Neuritic plaques, neurofibrillary tangles

Question 8

Donepezil treats? Function? side effects

Answer 8

Alzheimer’s
cholinesterase inhib
insomnia, muscle cramp

Question 9

Galantamine treats? Function? side effects

Answer 9

Alzheimer’s
cholinesterase inhib
wt loss, avoid with bad liver/kidney

Question 10

Rivastigmine treats? Function, side effects

Answer 10

Alzheimers and Parkinson’s dementia
cholinesterase inhib
minimal - no liver mtab, no drug intxn

Question 11

Memantine tx, function, side effects

Answer 11

Alzheimers
NMDA antagonist
Few side effects or interactions

Question 12

Lewy body dementia sx

Answer 12

Fluctuating cognition
visual hallucinations
parkinsonism (after cognitive)

Question 13

Parkinson’s disease DA agonists

Answer 13

Ropinirole
Pramipexole
Rotigotine
Apomorphine

Question 14

Corticobasal degeneration sx

Answer 14

• L-dopa unresponsive parkinsonism
• alien hand
• asymmetric limb dystonia, apraxia, myoclonus, neglect, cortical sensory loss
• FT type dementia

Question 15

Corticobasal degen imagine

Answer 15

asymmetric cortical atrophy

Question 16

PSP sx

Answer 16

Axial rigidity
dysphagia
early falls
vertical (esp down) gaze palsy
FT type dementia

Question 17

PSP imaging

Answer 17

Midbrain atrophy (hummingbird sign)

Question 18

MSA sx

Answer 18

Parkinsonism and/or cbl dysfxn

severe autonomic dysfxn

Question 19

MSA imaging

Answer 19

“hot cross bun”

Question 20

Dopa-responsive dystonia sx

Answer 20

Twisted foot, gait abnormality
worse in evening
poss parkinsonism
child/young adult
very responsive low dose L-dopa

Question 21

Wilson’s disease gene & inheritance

Answer 21

Gene ATP7B copper transporter

AD

Question 22

Wilson’s disease dx

Answer 22

Dysarthria, gait change
tremor, dystonia, parkinsonism
psych disease, dementia

Question 23

Wilson’s disease imaging

Answer 23

T2 hyper, T1 hypo basal ganglia

Question 24

Wilson’s disease labs

Answer 24

24hr urine copper high, ceruloplasmin low

Question 25

Wilson’s disease treatments

Answer 25

Penicillamine
trientine
zinc

Question 26

Huntington’s gene

Answer 26

CAG trinuc repeat huntingtin gene, chr 4

Question 27

Huntington’s sx

Answer 27

Hyperkinetic mvt (chorea, myoclonus)
Poor voluntary mvt (dex, slurred speech)
Difficulty swallowing, falls

Subcortical cognitive - loss speed and flexibility

Question 28

Huntington’s tx

Answer 28

Tetrabenazine (only helps hyperkinetic mvts)

Question 29

Ataxia telangiectasia gene

Answer 29

ATM, chr 11. Immune!

Question 30

Ataxia telangiectasia sx

Answer 30

Ataxia
tiny red spidery veins (esp face), dilated vessels eyes
Frequent sinopulmonary infxns

Question 31

Ataxia telangiectasia labs

Answer 31

increased AFP, CEA

Decreased Ig G, A, E

Question 32

Neuroacanthocytosis sx

Answer 32

lip/tongue biting –> oral “eating’ dystonia, tics, chorea
akinetic/rigid feet
vertical ophthalmophegia
sz