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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
Q

A wedge-shaped mass of gray matter whose broad convex base is directed laterally and its blade medially

A

Lentiform nucleus

26
Q

In the lentiform nucleus, what is related laterally to a thin sheet of white matter?

external capsule or claustrum

A

external capsule

27
Q

A thin sheet of gray matter separated from the lateral surface of the lentiform nucleus by the external capsule

A

claustrum

28
Q

Has reciprocal connection with all cortical areas including insular & visual cortex and limbic system

A

claustrum

29
Q

its function is the regulation of emotion and sexual arousal

A

claustrum

30
Q

it gives the basal ganglia control over emotions and other sexual functions

A

Limbic system

31
Q

True or False. Direct Pathway facilitates movement dopamine acts on D1 receptors

A

true

32
Q

True or False. Indirect pathway Inhibits movementdopamine acys on D2 receprors

A

true

33
Q

Are the following correctly matched?
Cerebral Cortex - excitatory, glutaminergic
Thalamus - (intralaminar nuclei) excitatory
Midbrain - Serotonergic
Raphe nuclei – dopaminergic

A

NO
Cerebral Cortex - excitatory, glutaminergic
Thalamus - (intralaminar nuclei) excitatory
Midbrain - dopaminergic
Raphe nuclei – Serotonergic

34
Q

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

A

none, everything is correct

35
Q

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

A

movement disorders

36
Q

other term for movement disorders

A

EXTRAPYRAMIDAL DISORDERS

37
Q

Parkinson’s disease
Due to increased activity of indirect pathway

hypokinetic or hyperkinetic

A

hypokinetic

38
Q

Huntington’s disease, Choreoathetosis, Hemiballismus, Dystonia
Due to decreased activity of indirect pathway

hypokinetic or hypokinetic

A

hyperkinetic

39
Q

what is Paralysis Agitans? its hallmark feature is bradykinesia and cogwheel type rigidity

A

parkinsons disease

40
Q

Enumerate the medical treatment for parkinsons disease

A

Dopaminergic agents
Levodopa + Carbidopa
Dopamine - agonist (Piribidil, Pramipexole)
COMT and MAO inhibitors (Entacapone, Selegiline)
Anticholinergics
Amantadine

41
Q

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

A

Chorea

42
Q

treatment for chorea

A

*Dopamine receptor-blocking agents
clonazepam
amantadine

43
Q

True or False. the pathology of huntingtons disease = loss of neurons in the caudate and putamen

A

True

44
Q

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

A Postural tremor

45
Q 
Tremor evident during any kind of movement
A Postural tremor
B Kinetic tremor
C Intention (terminal) tremor
D Task-specific tremor
E Isometric Tremors
A

B Kinetic tremor

46
Q 
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
A

C Intention (terminal) tremor

47
Q 
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
A

D Task-specific tremor

48
Q 
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
A

E Isometric Tremors

49
Q

Autosomal dominant disorder (Chromosome 4)

A

HUNTINGTON’S DISEASE

50
Q

it is caused by complex interaction between diverse mechanical and neuromuscular factors

A

physiologic tremors

51
Q

it is the most common, monosymptomatic, postural tremor

A

essential tremors

52
Q

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

A

TRUE

53
Q

what disorder has the following:
Postural, localized and irregular in amplitude and periodicity
Myoclonus a frequent accompaniment
Jerky in overall appearance

A

DYSTONIC TREMORS

54
Q

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

A

HEMIBALLISMUS

55
Q

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

A

DYSTONIA

56
Q

A type of dytonia that only becomes evident on moving

A. Action dystonia
B. Task specific dystonia
C. Overflow dystonia
D. “myoclonic” dystonia

A

A. Action dystonia

57
Q

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

A

B. Task specific dystonia

58
Q

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

A

C. Overflow dystonia

59
Q

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

A

D. “myoclonic” dystonia

NEUROLOGY 2 (3 decks)

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