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NEUROLOGY 2 > Module 3 - Evaluation of a Patient with Involuntary Movement and Approach to a Patient with Headache > Flashcards

Module 3 - Evaluation of a Patient with Involuntary Movement and Approach to a Patient with Headache Flashcards

1
Q

True or false: all headaches, tend to be dull, aching and not sharply localize

A

False

Some with superficialn origin.
DESCRIBED AS : PRIcKING OR STINGING TYPE OF PAIN

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2
Q

A patient comes to you with a cc of throbbing pain, which of the following will you consider the origin of the pain?

A. neurologic in origin
B. Muscular
C. Skull fx
D. Vascular in origin

A

D

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3
Q

One of your neighbor comes to you with pain on the frontotemporal area. Which of the ff can cause this symptom?

A. Glaucoma
B.Sinusitis
C. Thrombosis of the vertebral artery
D. Supratentorial lesion

A

D

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4
Q

True or false: pain experienced on migraine can be terminated by sleep?

A

True

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5
Q

Which of the ff can present with, clocklike regularity, upon awakening or in midmorning, and can be worsened in stoop position and changes in atmospheric pressure?

A. Headache from nasal sinus infection
B. Headaches origin in cervical origin
C. Mentrual headache
D. Nota

A

A

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6
Q

What type of pain can be felt at the tip of the skull up to the occipital area that can also reach the upper cervical nerve root of the neck?

A. Supratentorial pain
B. Infratentorial pain

A

B

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7
Q

This is a good prognosticating factor for Parkinson’s disease?

A. Tremors at onset
B. Cognitive deficit
C. Bradykinesia at onset
D. Late age at onset

A

A

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8
Q 
This movement disorder resulting from atrophy of the striatum?
A. Dystonia 
B. Hemiballismus
C. Chorea
D. Athetosis
A

C

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9
Q 
Which of the ff autonomic manifestations are usually found in parkinsonism?
A. Excessive perspiration 
B. Seborrhea
C. Salivary drooling
D. AOTA
E. NOTA
A

D

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10
Q 
This is a neurodegenerative disease characterized by choreiform movements and progressive dementia?
A. Chorea
B. Huntington's dse
C. MS
D. PD
A

B

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11
Q

Persistent posturing of one or more extremities, trunk, neck and face?

A

Dystonia

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12
Q

Type of tremor seen in patient with PD?

A

Resting tremor

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13
Q 
all of the ff were considered as primary headache except for
A. Migraine 
B. Tension type headache
C. Cluster headache
D. Idiopathic headache syndrome
A

D

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14
Q

Mr. Extra chromosome A 39-year with a history of smoking and heavy alcohol intake. He reports debilitating headaches that are stabbing in the right frontal region and associated with drooping of the eyelid and nasal drainage on the right
side. they often wake him from sleep an hour after he goes to bed. He cannot get comfortable and usually paces around the room. What most likely the diagnosis???

A

Cluster headache
S/sx
Severe, unilateral periorbital headache, accompanied by lacrimation, rhinorrhea/nasal congestion, miosis, ptosis, eyelid edema, or conjunctival injection.

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15
Q 
All are True about migraines except 
A. It can be unilateral
B. It can be bilateral
C. The quality of pain is usually stabbing, boring, burning
D. Can be any time 
E. NOTA
A

C

stabbing, boring, burning can be seen in cluster headache

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16
Q

Patient JC 23 y/o female came to your clinic with a cc of headache for 2 days that last for more than 4 hours, accompanied with nausea, no miosis noted. Based on the data what most likely the diagnosis?

A

Migraine

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17
Q

Precentral gyrus of the frontal cortex stimulation elicits movements

A

Primary Motor Cortex

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18
Q

Axons from Primary Motor Cortex go to ________ while other motor axons go to the ________

A

basal ganglia,

brainstem & spinal cord

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19
Q

Axons from the motor cortex taht go to the basal ganglia comprises the ________

A

extrapyramidal system

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20
Q

adjacent to the thalamus spiral shape structure (apostrophe) and closely associated with amygdala and thalamus

A. basal ganglia
B. putamen
C. caudate nucleus
D. substantia nigra

A

A. Basal Ganglia

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21
Q

it is part of the basal ganglia that is the one adjacent to the lateral ventricle

A

Caudate nucleus

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22
Q

what is part of the Striatum:

A. Caudate
B. Globus pallidus
C. Lentiform nucleus
D. Putamen

A

A. Caudate

D. Putamen

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23
Q

what is part of the Lentiform Nucleus:

A. Putamen
B. Globus pallidus
C. Caudate nucleus
D. Substantia nigra

A

A. Putamen

B. Globus pallidus

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24
Q

Corpus Striatum:

A. Caudate nucleus
B. Putamen
C. Globus pallidus
D. Substantia nigra

A

A. Caudate nucleus
B. Putamen
C. Globus pallidus

25
A wedge-shaped mass of gray matter whose broad convex base is directed laterally and its blade medially
Lentiform nucleus
26
In the lentiform nucleus, what is related laterally to a thin sheet of white matter? external capsule or claustrum
external capsule
27
A thin sheet of gray matter separated from the lateral surface of the lentiform nucleus by the external capsule
claustrum
28
Has reciprocal connection with all cortical areas including insular & visual cortex and limbic system
claustrum
29
its function is the regulation of emotion and sexual arousal
claustrum
30
it gives the basal ganglia control over emotions and other sexual functions
Limbic system
31
True or False. Direct Pathway facilitates movement dopamine acts on D1 receptors
true
32
True or False. Indirect pathway Inhibits movementdopamine acys on D2 receprors
true
33
Are the following correctly matched? Cerebral Cortex - excitatory, glutaminergic Thalamus - (intralaminar nuclei) excitatory Midbrain - Serotonergic Raphe nuclei – dopaminergic
NO Cerebral Cortex - excitatory, glutaminergic Thalamus - (intralaminar nuclei) excitatory Midbrain - dopaminergic Raphe nuclei – Serotonergic
34
which of the following is not a function of the basal ganglia? a. Integrates feeling and movement b. Initiates internally generated movements c. Shifts and smoothes fine motor behavior d. Suppresses unwanted motor behaviors e. Enhances motivation f. Allows feelings of pleasure/ecstasy
none, everything is correct
35
Neurological syndromes where they may be excess of movement or a paucity of movement that is not connected to weakness, paralysis or spasticity of the muscles
movement disorders
36
other term for movement disorders
EXTRAPYRAMIDAL DISORDERS
37
Parkinson’s disease Due to increased activity of indirect pathway hypokinetic or hyperkinetic
hypokinetic
38
Huntington’s disease, Choreoathetosis, Hemiballismus, Dystonia Due to decreased activity of indirect pathway hypokinetic or hypokinetic
hyperkinetic
39
what is Paralysis Agitans? its hallmark feature is bradykinesia and cogwheel type rigidity
parkinsons disease
40
Enumerate the medical treatment for parkinsons disease
Dopaminergic agents Levodopa + Carbidopa Dopamine - agonist (Piribidil, Pramipexole) COMT and MAO inhibitors (Entacapone, Selegiline) Anticholinergics Amantadine
41
It has quick, repeated involuntary, non-purposeful movements of the distal extremity, face and tongue associated with lesions of the corpus striatum Seen in Huntington’s disease
Chorea
42
treatment for chorea
*Dopamine receptor-blocking agents clonazepam amantadine
43
True or False. the pathology of huntingtons disease = loss of neurons in the caudate and putamen
True
44
Tremor apparent during the voluntary maintenance of a particular posture which is opposed by the force of gravity ``` A Postural tremor B Kinetic tremor C Intention (terminal) tremor D Task-specific tremor E Isometric Tremors ```
A Postural tremor
45
``` Tremor evident during any kind of movement A Postural tremor B Kinetic tremor C Intention (terminal) tremor D Task-specific tremor E Isometric Tremors ```
B Kinetic tremor
46
``` Pronounced exacerbation of kinetic tremor towards the end of a goal-directed movement A Postural tremor B Kinetic tremor C Intention (terminal) tremor D Task-specific tremor E Isometric Tremors ```
C Intention (terminal) tremor
47
``` Tremor which only occurs to any significant extent during the performance of highly skilled activities such as writing, playing a musical instrument or using a jeweller’s screwdriver A Postural tremor B Kinetic tremor C Intention (terminal) tremor D Task-specific tremor E Isometric Tremors ```
D Task-specific tremor
48
``` Tremor which occurs when a voluntary muscle contraction is opposed by a rigid stationary object A Postural tremor B Kinetic tremor C Intention (terminal) tremor D Task-specific tremor E Isometric Tremors ```
E Isometric Tremors
49
Autosomal dominant disorder (Chromosome 4)
HUNTINGTON’S DISEASE
50
it is caused by complex interaction between diverse mechanical and neuromuscular factors
physiologic tremors
51
it is the most common, monosymptomatic, postural tremor
essential tremors
52
TRUE OR FALSE. The pathophysiology of essential tremors are the following Central oscillations arising in the Guillain- Mollaret triangle (red nucleus, inf olive, dentate nucleus) Inferior olive believed to function abnormally
TRUE
53
what disorder has the following: Postural, localized and irregular in amplitude and periodicity Myoclonus a frequent accompaniment Jerky in overall appearance
DYSTONIC TREMORS
54
what disorder has the following: An unusual movement disorder Large, flailing movements of one extremity or the arm and the leg on one side Results from damage to the contralateral subthalamic nucleus Usually results from strokes of the PCA
HEMIBALLISMUS
55
what disorder has the following: Sustained muscle contraction causing twisting or abnormal postures or repetitive movements Movements are patterned : same group of muscles are involved
DYSTONIA
56
A type of dytonia that only becomes evident on moving A. Action dystonia B. Task specific dystonia C. Overflow dystonia D. “myoclonic” dystonia
A. Action dystonia
57
A type of dytonia where in it appears when performing a particular action (e.g. writing) A. Action dystonia B. Task specific dystonia C. Overflow dystonia D. “myoclonic” dystonia
B. Task specific dystonia
58
A type of dytonia thatoccurs in a body part during movement of another body part (e.g. dystonia of the left hand when writing with the right hand) A. Action dystonia B. Task specific dystonia C. Overflow dystonia D. “myoclonic” dystonia
C. Overflow dystonia
59
A type of dytonia where in intermittent spasms appear rather than sustained, it may appear jerky A. Action dystonia B. Task specific dystonia C. Overflow dystonia D. “myoclonic” dystonia
D. “myoclonic” dystonia

NEUROLOGY 2 (3 decks)

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