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Neuro - Week 4 > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Is Multiple system atrophy (MSA) a hypokinetic or hyperkinetic disorder?

A

Hypokinetic

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2
Q

Is progressive supranuclear palsy (PSP) a hypokinetic or hyperkinetic disorder?

A

Hypokinetic

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3
Q

Is corticobasal degeneration (CBD) a hypokinetic or hyperkinetic disorder?

A

Hypokinetic

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4
Q

Parkinson’s disease is caused by a loss of cells that produce this neurotransmitter in the substantia nigra pars compacta

A

Dopamine

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5
Q

Parkinson’s disease is caused by the loss of dopamine-producing cells in this structure

A

Substantia nigra pars compacta

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6
Q

“TRAPS” is an acronym for the symptoms of Parkinson’s disease, and stands for this

A

Tremor at rest
Rigidity
Akinesia/bradykinesia
Postural instability / flexed balance
Shuffling gait

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7
Q

Can Parkinson’s disease present with hallucinations and psychosis?

A

Yes (usually drug induced)

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8
Q

Does Parkinson’s disease disrupt sleep?

A

Yes

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9
Q

Does Parkinson’s disease cause orthostatic hypo- or hyper-tension

A

Hypotension

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10
Q

Olfactory disturbances can occur in this condition characterized by resting tremor, rigidity, or bradykinesia

A

Parkinson’s disease

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11
Q

This occurs when symptoms similar Parkinson’s disease are caused by certain medicines, a different nervous system disorder, or another illness
(examples: viral encephalitis, microvascular lesions, dopamine antagonists)

A

Secondary Parkinsonism

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12
Q

Does idiopathic Parkinson’s disease present with unilateral or bilateral onset of symptoms?

A

Unilateral

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13
Q

Does Multiple system atrophy present with symmetric or asymmetric symptoms?

A

Symmetric

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14
Q

Does corticobasal degeneration present with symmetric or asymmetric symptoms?

A

Marked asymmetric symptoms

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15
Q

Hypokinetic disorder with early autonomic dysfunction, early falls and gait difficulty

A

Multiple system atrophy

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16
Q

Hypokinetic disorder with oculomotor abnormalities

A

Progressive supranuclear palsy

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17
Q

Hypokinetic disorder with apraxia, alien limb phenomenon, loss of limb function

A

Corticobasal degeneration

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18
Q

Hypokinetic disorder with normal MRI

A

Idiopathic Parkinson’s disease

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19
Q

Hypokinetic disorder with Hot cross bun sign and Putaminal rim sign on MRI

A

Multiple system atrophy

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20
Q

Hypokinetic disorder with Humming bird sign and Micky mouse sign on MRI

A

Progressive supranuclear palsy

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21
Q

Hypokinetic disorder with asymmetric parietal and/or frontal cortical atrophy seen on MRI

A

Corticobasal degeneration

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22
Q

Is MRI normal in Parkinson’s disease?

A

Yes

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23
Q

What is the average age of diagnosis for Parkinson’s disease?

A

55-60 years of age

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24
Q

These two genes linked to Parkinson’s disease have an autosomal dominant pattern

A

LRRK2 (kinase) and SNCA (alpha-synuclein)

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25
Q

These three genes linked to Parkinson’s disease have an autosomal recessive pattern

A

PARK2 (parkin protein), PARK7 (DJ-1 protein), and PINK1 (kinase)

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26
Q

LRRK2 (kinase) and SNCA (alpha-synuclein) are genes associated with Parkinson’s disease with this inheritance pattern

A

Autosomal dominant

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27
Q

PARK2 (parkin protein), PARK7 (DJ-1 protein), and PINK1 (kinase) are genes associated with Parkinson’s disease with this inheritance pattern

A

Autosomal recessive

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28
Q

Clumping of this misfolded protein forms Lewy bodies

A

Alpha synuclein
(binds ubiquitin in damaged cells)

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29
Q

Is there a cure for Parkinson’s disease?

A

No

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30
Q

Levodopa is a treatment for this condition

A

Parkinson’s disease

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31
Q

Central conversion of this drug to dopamine allows enhancement of dopamine levels in the remaining nerve terminals, ‘restoring’ net function in the basal ganglia in Parkinson’s disease

A

Levodopa

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32
Q

Levodopa is a precursor to this molecule

A

Dopamine

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33
Q

Does dopamine cross the blood brain barrier?

A

No

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34
Q

Does levodopa cross the blood brain barrier?

A

Yes
(using the competitive aromatic acid transport system)

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35
Q

Absorption of Levodopa can be enhanced by doing this

A

Taking drug on empty stomach
(or with low protein foods)

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36
Q

This enzyme converts levodopa to dopamine outside of the CNS

A

Peripheral decarboxylase

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37
Q

Is carbidopa a reversible or irreversible inhibitor of peripheral decarboxylase?

A

Reversible

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38
Q

Peripheral decarboxylase can be blocked by this reversible inhibitor to enhance net central conversion of dopa to dopamine

A

Carbidopa

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39
Q

Carbidopa is given to enhance the effect of this Parkinson’s drug

A

Levodopa

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40
Q

This symptom of Parkinson’s shows the least improvement with treatment of Levodopa

A

Postural defects

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41
Q

Postural defects show the least improvement with this Parkinson’s drug

A

Levodopa

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42
Q

Peripheral adverse effects of levodopa caused mainly by dopamine (Nausea and vomiting, orthostatic hypotension, cardiac arrhythmias) are all reduced by use of this drug

A

Carbidopa

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43
Q

How can central adverse effects of levodopa (anorexia, visual and auditory hallucinations, dyskinesias) be reduced?

A

Lowering dose or drug holiday

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44
Q

How can peripheral adverse effects of levodopa (Nausea and vomiting, orthostatic hypotension, cardiac arrhythmias) be reduced?

A

Use carbidopa

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45
Q

Carbidopa is a reversible inhibitor of this

A

Peripheral decarboxylase

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46
Q

This drug for Parkinson’s disease has response fluctuations

47
Q

This direct dopamine agonist should be given with levodopa when there is slow onset of action (delayed ON or no ON)

A

Apomorphine

48
Q

Apomorphine is an agonist of this

49
Q

This drug should be given when there is sudden return of symptoms with levodopa use (ON-OFF dyskinesias)

A

Amantadine

50
Q

Either of these should be given with levodopa when there is a return of symptoms shortly before the next scheduled dose (end-of-dose or wearing OFF reactions)

A

COMT or MAO-B inhibitors
or dopamine agonist
(can also increase dose frequency)

51
Q

Bromocriptine is this type of drug

A

Dopamine receptor agonist

52
Q

Apomorphine is this type of drug

A

Dopamine receptor agonist

53
Q

Pramipexole is this type of drug

A

Dopamine receptor agonist

54
Q

Ropinirole is this type of drug

A

Dopamine receptor agonist

55
Q

Rotigotine is this type of drug

A

Dopamine receptor agonist

56
Q

This type of drug can be used as monotherapy or as adjunct to L-DOPA for Parkinson’s disease

A

Direct Dopamine receptor agonists

57
Q

This type of drug for Parkinson’s disease can also be used for restless leg syndrome

A

Direct dopamine receptor agonists

58
Q

This type of drug for Parkinson’s disease must be used while L-DOPA is still beneficial, and has more adverse effects than with Levodopa

A

Direct dopamine receptor agonists

59
Q

Compulsive behaviors, such as increased gambling, can be seen with this type of drug for Parkinson’s disease

A

Direct dopamine receptor agonists

60
Q

This drug for Parkinson’s disease has a short-lived amphetamine-like effect

A

Amantadine

61
Q

Amantadine is an antagonist of this receptor

62
Q

Is Amantadine an agonist or antagonist of the NDMA receptor?

A

Antagonist

63
Q

Drug for Parkinson’s disease that is unique in that it doesn’t directly replace dopamine like levodopa, but instead modulates dopamine activity

A

Amantadine

64
Q

This is the primary degradative enzyme for dopamine in the brain

A

Monoamine oxidase B

65
Q

Selegiline is an irreversible inhibitor of this enzyme

A

Monoamine oxidase B

66
Q

Is Selegiline a reversible or irreversible inhibitor of MAO-B?

A

Irreversible

67
Q

Selegiline should not be used if the patient has taken this opioid analgesic

A

Meperidine

68
Q

This MAO-B inhibitor should not be given if the patient has taken meperidine

A

Selegiline

69
Q

Hallucinations, insomnia, jitteriness, dyskinesia and delusions may be amphetamine/methamphetamine response adverse effects of this drug for Parkinson’s disease

A

Selegiline

70
Q

MAO-B inhibitor with lower risk of hallucinations, insomnia, jitteriness, and delusions
May be neuroprotective

A

Rasagiline

71
Q

Which MAO-B inhibitor has lower risk of hallucinations, insomnia, jitteriness: Selegiline or Rasagiline?

A

Rasagiline

72
Q

COMT inhibition slows dopa conversion in periphery to this

A

3-O-methyldopa

73
Q

This is the primary dopamine degradative enzyme in the periphery

A

Catechol-O-methyltransferase (COMT)

74
Q

Inhibitors of this are especially good in managing response fluctuations associated with levodopa therapy

A

Catechol-O-methyltransferase (COMT) inhibitors

75
Q

This Catechol-O-methyltransferase (COMT) inhibitor crosses the blood brain barrier
(may prolong central duration of dopamine)

76
Q

Tolcapone is this type of drug

A

Catechol-O-methyltransferase (COMT) inhibitor

77
Q

Entacapone is this type of drug

A

Catechol-O-methyltransferase (COMT) inhibitor

78
Q

Diarrhea and orange discoloration of urine are adverse effects of this type of drug for Parkinson’s disease

A

Catechol-O-methyltransferase (COMT) inhibitor

79
Q

Hepatic necrosis can occur with this Catechol-O-methyltransferase (COMT) inhibitor

80
Q

This drug is a combination of entacapone, levodopa and carbidopa, designed to allow patients to take one pill rather than two

81
Q

Trihexyphenidyl is this type of drug

A

Anticholinergic
(treats Parkinson’s)

82
Q

This type of drug for Parkinson’s disease is used when the primary complain is tremor

A

Anticholinergic drugs
(e.g. Trihexyphenidyl)

83
Q

Anticholinergic drugs (e.g. Trihexyphenidyl) are used in Parkinson’s disease when this symptom is the primary complaint

84
Q

This vitamin may enhance the breakdown of levodopa into dopamine, particularly in peripheral tissue, which may reduce its effectiveness

85
Q

Central side effects of levodopa include psychosis, which should be treated with this drug

A

Pimavanserin

86
Q

This type of drug for Parkinson’s disease is likely to have significant interactions with peripheral adrenergic agents

A

MAO inhibitors

87
Q

Do Selegiline, Rasagiline, and Safinamide inhibit central or peripheral dopamine degradation?

A

Central
(inhibit MAO)

88
Q

Do Entacapone and Tolcapone inhibit central or peripheral dopamine degradation?

A

Peripheral
(COMT inhibitors)

89
Q

This MAO inhibitor has a mixed agonist metabolite that increases risk of psychosis

A

Selegiline

90
Q

Selegiline has a mixed agonist metabolite that increases the risk of this adverse effect

91
Q

This COMT inhibitor may cause liver damage

92
Q

Tolcapone is a COMT inhibitor that may cause damage to this organ

93
Q

This type of drug for Parkinson’s disease has a higher level of confusion and hallucination

A

Anticholinergics
(e.g. Trihexyphenidyl)

94
Q

Anticholinergics (trihexyphenidyl) and/or amantadine are used in Parkinson’s disease when this symptom is the primary problem

95
Q

This is the treatment for fluctuating, dyskinetic Parkinson’s disease without dementia after exhausting medical options

A

Surgical treatment

96
Q

These two structures are the common targets for deep brain stimulation in Parkinson’s disease

A

Subthalamic nucleus and Globus pallidus internus

97
Q

This structure is a common target for deep brain stimulation in essential tremor

A

Ventral intermediate nucleus (VIM) of the thalamus

98
Q

This structure is a common target for deep brain stimulation in Dystonia

A

Globus pallidus internus

99
Q

This structure is a common target for deep brain stimulation in Huntington’s disease

A

Globus pallidus internus

100
Q

This structure is a common target for deep brain stimulation in Tourette’s syndrome

A

Globus pallidus internus

101
Q

Essential tremors usually respond to this type of drug

A

Beta blockers
(e.g. propranolol)

102
Q

Ventral intermediate nucleus (VIM) of the thalamus is the most common deep brain stimulation target in this condition

A

Essential tremor

103
Q

Involuntary, sustained, patterned and repetitive muscle contractions of muscles leading to twisting postures

104
Q

This is the first line therapy for focal dystonia

A

Botulinum toxin

105
Q

Are levels of glutamate, acetylcholine, and GABA reduced or increased in Huntington’s disease?

A

Reduced
(due to loss of caudate)

106
Q

This structure of the basal ganglia is lost in Huntington’s disease, leading to reduced glutamate, acetylcholine, and GABA

107
Q

Tetrabenazine or reserpine can be used to treat this condition

A

Huntington’s disease

108
Q

What age does Tourette’s syndrome begin?

109
Q

What is the treatment for Tourette’s syndrome?

A

Antipsychotic (e.g. haloperidol)

110
Q

Autosomal recessive genetic disorder in which excess copper builds up in the body

A

Wilson’s disease

111
Q

What is the inheritance pattern of Wilson’s disease?

A

Autosomal recessive

112
Q

Wilson’s disease is a disorder that results in excess of this that builds up in the body

113
Q

Wilson’s disease involves this chromosome

Neuro - Week 4 (9 decks)

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