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PCM > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Hypokinetic Disorders

A

Parkinsons Disease

Parkinsonian like disease

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2
Q

Hyperkinetic disorders or symptoms

A

termor
dystonia
chorea

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3
Q

Parkinson Disease (PD)- pathology

A

Lose DA projections from substantia nigra to the caudate and putamen- the nigrostriatal tracts

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4
Q

PD and Lewy bodies

A

Lewy bodies are alpha synuclein deposits ni the cytoplasm of the nigrostriatal pathway neurons

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5
Q

SSx and PD

A 
STRAPD
shuffling gait
tremor- resting, pill rolling
Rigidity- cogwheel rigidity
Akinesia/bradykinesia- slow absence of movement 
Autonomic dysfunction- orthostasis, neurognenic bladder, constipation, ED
Postural Instability
Dementia, depression
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6
Q

Dx

A

Clinical

can only see substantia nigra is on autopsy

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7
Q

Treatment-

A

Cinemet- Carbidopa/ Levadopa
anticolonergics- benztropine
dopamine receptor agonists
COMT and MAOD inhibitors

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8
Q

Best drug for depression in PD

A

Amitryptilline

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9
Q

Best drugs for psychosis in PD

A

Clonazapine, Olanzapine, Quitiapine

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10
Q

Best drugs for dementia in PD

A

donepezil and rivastigmine

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11
Q

Surgery and PD tx

A

use DBS of STB, GPI and VIM

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12
Q

Essential tremor

A

Rhythmic oscillating movements of agonits and antagonist resulting in an intention tremor.
most common hyperkinetic disorder

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13
Q

What parts of the body does ET affect

A

posture, heads, neck, and hands

worsens with movement

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14
Q

Essential tremor- etiology

A

AD inheritance

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15
Q

ET- age of onset

A

bimodal distribution in 20s and 60s

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16
Q

ET- treatment

A

Pts often self medicate with alcohol

beta blockers ie propranolol work

17
Q

Dystonia- definition

A

involuntary sustained muscle contraction leading to twisting or repetitive movements.

18
Q

Focal dystonia- types

A

Torticollis

Bleophasm

19
Q

Global dystonia- etiology

A

hereditary

or medication induced- antipsychotics, metaloclopramide

20
Q

Treatment of Dystonia

A 
Anticholinergics
Muscle relaxants
Botox
Sx
DBS
21
Q

How does botox work

A

Botox blocks presynaptic ACH receptors by inhibiting one of the 3 types of proteins that make up the SNARE complex.
Each type of botox (A,B,C) inhibit a dif protein in the SNARE complex.

22
Q

Torticollis

A

dystonia of the SCM and Trap so the head points towards the effected SCM and the chin points away from it

23
Q

Huntington disease- etiology

A

AD mutation on chromosome 4- CAG repeats

24
Q

HD- changes in the brain

A

atrophy of caudate caused by frank neuronal loss

25
Q

What is anticipation, how does it relate to HD

A

HD exhibits anticipation
diz presents earlier and causes death earlier the larger the repeat gets.
the repeat ges larger every generation

26
Q

HD- SSx

A 
chorea
dementia
lack of coordination
personality changes
depression and anxiety
27
Q

HD- Dx

A

chromosomal analysis

28
Q

HD- tx

A

none

symptomatic relief with neuroleptics and benzos

29
Q

Wilsons dz

A

hepatorenticuar degeneration

30
Q

WD- damages what organs

A

liver and brain

31
Q

WD liver damage

A

defective hepatic transport of Cu into bile for excretion –> cirrhosis, inc Cu in liver and spleen

32
Q

WD- lenticular damage

A

Cu builds up in putamen and subhalamic nucleus –> PD like movement disorders or hemiballismus

33
Q

WD- lab findings

A

Cu deposits in tissues
total serum Cu is low but free urine and reum Cu are higher in later stages
Serum Ceruloplasmin is low

34
Q

WD- clinical findings

A

Kayser Fleischer ring
movement disorders- hemibalismus, dementia
hepatosplenomegaly
hemolytic anemia
renal dz- fanconi syndrome b.c of damage to proximal tubules –> inc excretion of glucose AA, and Phosphate

35
Q

WD- tx

A

penicilalmine
Zn
liver transplant

PCM (12 decks)

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