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Clin Med 3 Final Exam > Lecture 3-movement disorders > Flashcards

Lecture 3-movement disorders Flashcards

1
Q

a state of restlessness

A

akathisia

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2
Q

inability to coordinate movements of the trunk or limbs

A

ataxia

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3
Q

involuntary writhing limb movements

A

athetosis

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4
Q

flailing, ballistic, involuntary movements in a limb

A

ballism

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5
Q

quick, involuntary, dance-like movements

A

chorea

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6
Q

involuntary movements, chorea-like or tic-like

A

dyskinesias

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7
Q

abnormal muscle tone with sustained posture

A

dystonia

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8
Q

involuntary, spasmodic, jerky movements

A

myoclonus

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9
Q

habitual, semi-voluntary, spasmodic, quick, brief movements

A

tics

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10
Q

involuntary, rhythmic, repetitive movement

A

tremor

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11
Q

2nd most common neurodegenerative disease following alzheimer’s

A

idiopathic parkinson’s disease

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12
Q

when do motor complications appear in idiopathic parkinson’s disease

A

~5-7 years after disease

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13
Q

do you see an overactive or underactive indirect pathway in IPD?

A

overactive

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14
Q

4 cardinal features of IPD

A
  • rest tremor (unilateral)
  • rigidity
  • akinesia-bradykinesia
  • postural instability (later sx)
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15
Q

unified parkinson’s disease rating scale

A

I: mentation, mood, and behavoir
II: ADLs
III: motor exam
IV: complications of therapy

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16
Q

drug-induced parkinsonism

A
  • offending drug (anti-nausea, anti-psychotics)
  • absence of rest tremor
  • SYMMETRIC sxs
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17
Q

vascular disease (diff. from parkinsonism)

A
  • GAIT DISTURBANCE (magnetic gait)
  • SPASTICITY
  • hyper-reflexia
  • pseudobulbar affect
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18
Q

normal pressure hydrocephalus

A

-APRAXIA OF GAIT
-regidity
urinary incontinence

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19
Q

corticobasal degeneration

A
  • COGNITIVE DISORDER
  • limb apraxia
  • dystonia or myoclonus
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20
Q

progressive supranuclear palsy

A
  • pseudobulbar affect
  • supranuclear gaze palsy
  • early falls
  • absence of tremor
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21
Q

multi-system atrophy

A
  • falls
  • axial dystonia
  • resp. stridor
  • absence of rest tremor
  • prominent autonomic features early on
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22
Q

dementia with lewy bodies

A
  • cognitive disorder

- hallucinations

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23
Q

workup for suspected parkinsonism

A
  • none if typical presentation

- MRI if gait disorder/falling, cognitive disorder

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24
Q

hot cross bus sign

A

MSA (multi-system atrophy)

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25
Q

hummingbird sign (thinning of midbrain)

A

PSP (progressive supranuclear palsy)

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26
Q

when should you r/o wilson’s disease?

A

any pt

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27
Q

workup for wilson’s ds

A

urine copper and serum ceruloplasmin

-ophth=K-F rings

28
Q

lab study for any pt with a tremor

A

thyroid studies

29
Q

lab you should get in all patients you follow with PD

30
Q

study for pts with dysphagia

A

swallow study

31
Q

study for all pts with a voice change

A

speech evaluation

32
Q

tx for IPD

A
  • Sinemet (L-dopa and carbidopa)

- DA agonists (pramipexole, ropinirole, rotigotine)

33
Q

who should take sinemet

A

all pts with IPD over the age of 70

34
Q

unique SE of DA agonists

A

impulse control disorders

35
Q

indications for DA agonists

36
Q

sx tx for IPD

A
  • MCI/dementia= anticholinesterases
  • depression/anxiety= antidepressants
  • constipation=increase fiber
  • orthostatic hypoTN=caffeine, water, stockings
  • sialorrhea= robinul (caution) or botulinum
37
Q

IPD surgical tx

A
  • ablative

- DBS

38
Q

indications for DBS

A

-significant disability, motor fluctuations with max medications, still levodopa responsice, no cognitive impairment

39
Q

indication for Vim DBS

A

ET or tremor predominant PD

40
Q

indication for STN DBS

41
Q

indication for GPi DBS

A

dystonia or rigidity prominent PD

42
Q

autosomal dominant inheritance with variable penetrance

A

essential tremor

43
Q

features of essential tremor

A
  • typically BUE
  • rest tremor later on
  • may improve with alcohol
44
Q

treatment for ET

A

wrist weights, propranolol, primidone, gabapentin, topiramate, etc

45
Q

criteria for RLS

A
  • abnl sensations with urge to move the legs
  • occurs at rest
  • alleviated by movement
  • sxs worse at night
46
Q

secondary causes of RLS

A

neuropathy, Fe deficient, pregnancy, renal failure

47
Q

Tx of RLS

A
  • only use at night!

- Fe replacment, DA agonists, anti-epileptics, benzos, opioids,

48
Q

chromosome involved with huntington’s disease

A

chromosome 4

-trinucleotide repeat (CAG)

49
Q

autosomal dominant with HIGH penetrance

A

huntington’s disease

50
Q

butterfly appearance of ventricles

A

huntington’s disease

51
Q

manifestations of HD

A
  • chorea, motor impersistence
  • cognitive deficits
  • psych (depression, suicide rate 5x general population)
52
Q

tx of HD

A
  • anti-dopaminergic drugs
  • benzos
  • anti-depressants
53
Q

Tics are a/w which other disorders

A

OCD and ADD

54
Q

etiology of Tics

A
  • primary: tourette’s
  • drug induced: stimulants, steroids, neuroleptics
  • post-infectious: post-strep
55
Q

tx of Tics

A
  • clonidine
  • neuroleptics
  • benzo
56
Q

criteria for tourette’s syndrome

A
  • motor tics and phonic tics for >1 year
  • no secondary causes
  • onset before age 18
  • copralalia (swearing)
57
Q

tx of tourette’s syndrome

A

meds, botox, DBS

58
Q

types of primary dystonia

A
  • generalized (childhood onset)

- focal (adult onset)

59
Q

types of secondary dystonia

A
  • neurocog. disorders

- medication

60
Q

tx of dystonia

A
  • dopaminergic
  • muscle relaxers
  • benzos
  • anticholinergics
61
Q

what is a hemifacial spasm

A

involuntary, intermittent spasms of half of the face

62
Q

triggers of hemifacial spasm

A

bright light, wind, fatigue, stress, smiling, speaking

63
Q

most common cause of HFS

A

CN 7 compression

64
Q

dx of HFS

A

clinical and MRI

65
Q

tx of HFS

66
Q

clinical features of functional/psychogenic movement disorders

A
  • abrupt onset with rapid progression
  • bizzare movement
  • spontaneous remissions
  • self inflicted injuries
  • give wat weakness
  • lateralization of tuning fork on frontal bone
  • hoover sign
  • astasia-abasia

Clin Med 3 Final Exam (6 decks)

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