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@N MEDICINE > Movement Disorder > Flashcards

Movement Disorder Flashcards

1
Q

CHOREA causes 🌟 CHOREA

A

CHOREA gravidarum
Huntingtons CHOREA
Ocp
Rheumatoid CHOREA
Endocrine ( thyrotoxicosis )
Arteriosclerotic / senile chorea

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2
Q

Types of movement disorder

A

Dykinetic
Hypokinetic
HYPERKINETIC

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3
Q

Cause of dyskinesia

A

Drug induced / tardive dyskinesia

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4
Q

Hypokinetic movement dis causes

A

Parkinsonism

Parkinson’s dis
Secondary parkin
Parkinson plus syndrome

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5
Q

Parkinson triad

A

Tremor
Rigidity
Bradykinesia

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6
Q

DEFN of Parkinson’s disease

A

Neurodegenerative progressive disorder characterized by. Tremor, rigidity, bradykinesia

Aka - paralysis agitans

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7
Q

Punch drunk syndrome

A

Secondary parkinsonism as a result of head injury

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8
Q

Classification of Parkinson’s disease

A
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9
Q

Hallmark of PD

A

Degeneration and depletion of dopaminergic neurons in Substantia nigra pars compacta

Presence of LEWY BODIES - tangles of Alpha synuclein and ubiquitin

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10
Q

LEWY bodies

A

Alpha synuclein + ubiquitin
Seen in Nigral cells ( Substantia nigra )

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11
Q

Environmental factors causing PD

A

Oxidative stress ( MPTP mitochondrial toxin )
Pesticide exposure
Smoking is protective

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12
Q

Genetic causes of PD

A

PARK 1-11 FAMILIAL
SPORADIC

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13
Q

Motor symptoms of PD

A

Tremor
Rigidity
Bradykinesia
Gait
Posture
Cognition
Speech

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14
Q

Tremor of PD

A

Pill rolling
4-6 hz
Prominent at rest
Worsens with emotional stress
Rythmic flexion extension
Disappears on sleep or voulntary movement

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15
Q

Rigidity of PD

A

Increased resistance to passive movements
Lead pipe rigidity ( aka)

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16
Q

Cogwgheel rigidity

A

Tremor superimposed on rigidity
Leading to jerkiness on passive resistance

17
Q

Bradykinesia of PD

A

Slowing of movements
Difficulty in voluntary movement
Fixed facial expressions - MASK LIKE FACIES
sustained blink response on Glabellar tap ( 2 hz) - MYERSONS SIGN
illegible / difficult handwriting - MICROGRAPHIA

18
Q

MYERSONS SIGN / REPTILIAN STARE SIGN

A

In PD
Sustained blink response on Glabellar tap at 2 hz
Progressive supranuclear palsy also +

19
Q

Posture in PD

A

Stooped

20
Q

Gait in PD

A

Slow shuffling
Frozen
Festinating ( rapid short steps)

21
Q

Speech in PD

A

Hypophonia - soft voice
Monotonous stuttering

22
Q

Cognitive changes in PD

A

Depression
Dementia
Sleep ABN

23
Q

Non motor symptoms of PD

A

ANS - hypotension , bladder bowel incontinence , sexual problem

NEUROPSYCHIATRIC- anxiety , depression , apathy , psychosis

SENSORY - hyposmia , pain

SLEEP ABN - Restless leg syndrome, insomnia , day time somnolence

RHEUMATOLOGICAL - Frozen shoulder , swan neck deformity

24
Q

Psp / Steele Richardson olszewski syndrome

A

PD + PSP
MRI - humming bird sign ( atrophy of mid brain )

25
Q

MSA / Shy drager syndrome / hot cross burn sign

A

Parkinson + cerebellar signs + prominent autonomic dysfunction

Hot cross burn sign - cerebellar brain stem atrophy

MSA - multiple system atrophy

26
Q

Corticobasal ganglionic degeneration / rebeiz kolodny Richardson syndrome

A

PD+ DYSTONIA OF LIMBS + CORTICAL DISTURBANCES ( apraxia, agnosia, myoclonus )

27
Q

Parkinsonism dementia complex guam

A

PD+ MND

28
Q

Guadelopean parkinsonism

A

Levidopa unresponsive Parkinson’s

29
Q

Causes of Asterixis / Flapping tremors 🌟 RUSH

A

Respiratory failure
Uremia
Severe heart failure
Hepatic failure

30
Q

Causes of tremors 🌟 WMAT PID

A
31
Q

Huntingtons CHOREA (🌟 huntingtons fourea )

A

Chromosome no 4
Increase in no of CAG REPEATS >40
POLYGLUTAMINE REPEATS

32
Q

Most common cause of Chorea in children

A

Syndrnhams chorea / Saint vitus dance
Complication of ARF , group A beta hemolytic streptococcal inf
Sign - motor impersostence

MGT - Sodium valproate 200mg tid
Haloperidol 0.5-1.5 mg BD
PEnicillin prophylaxis for future streptococcal inf

33
Q

Milk maid sign

A

Milking action of patients fingers if asked to grasp physicians hand
Seen in CHOREA

34
Q

Pronator sign

A

Seen in CHOREA
Inability to hold hands above the face with palms facing each other as it results in pronation of arms so that palms face outwards

35
Q

Jack in the box sign

A

Involuntary protrusion and retraction of tongue

36
Q

Features of extrapyramidal lesions 🌟 DR MCH²

A
37
Q

Site of lesion in CHOREA

A

Caudate nucleus

38
Q

Site of lesion in Hemiballisbus

A

Subthalamic nucleus

39
Q

Site of lesion in dystonia / athetosis

A

Putanen

@N MEDICINE (9 decks)

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