Neuro cases 2 Flashcards
A ______ is an involuntary, rhythmic, oscillatory movement of a body part and is the most common movement disorder that is seen in a primary care setting
tremor
What are some examples of the classifications of tremors
Resting Action Parkinsonian Cerebellar Psychogenic
A _______ tremor occurs in body part that is relaxed and completely supported against gravity; enhanced by mental stress or movement of another body part; diminished voluntary movement in that part
resting tremor
What are the three types of action tremors?
Postural
Isometric
Kinetic
A _______ tremor maintains the position against gravity
Postural
A _______ tremor is a tremor that occurs with a muscle contraction that is against a rigid stationary object
Isometric
________ tremor includes an intention tremor, which is produced with target directed movement
Kinetic
What is an enhanced physiologic tremor?
A tremor that everyone has that is low amplitude and high frequency at rest and can be enhanced by stress, anxiety, etc
Describe the essential classification of tremors
most common
usually kinetic
hands, LE, voice and is typically bilateral
Can be inherited
Describe the parkinsonism tremors
Most patients will exhibit a resting tremor followed by a classic tremor that starts as a pill rolling motion of the fingers
bradykinesia with movements; standing up, reduced arm swing while walking
Describe a cerebellar tremor
Low frequency, slow intension postural tremor that is caused by MS, cerebellar plaques, stroke, brainstem tumors
A _______ tremor tends to increase with attention and stop with distraction; typically seen in patients employed in allied health professions
Psychogenic
If a patient presented to the clinic with a resting tremor, decreased dexterity, soft voice, less arm swinging, sleep disturbances, decreased facial expression, shuffling, etc,
what would you think diagnostically?
Parkinsons
Differentiate between the handwriting that is seen with someone with parkinson’s disease versus a patient who has an essential tremor
The patient with PD will have small and illegible handwriting whereas the ET Will have tremulous and large handwriting
_______ is the loss of cognitive functioning-thinking, remembering, and reasoning to an extent that it interferes with everyday life and activities
Dementia
A ______ _______ ________ is a significant cognitive decline in at least one domain interfering with activities of daily living
Major neurocognitive disorder
A _______ _______ _______ is a modest disorder that does not interfere with daily living
minor neurocognitive disorder
What is a mini-cog test?
Patient is asked to repeat three unrelated words, perform a clock drawing, then relay the three words
How do you score the mini cog test
One point for each word remembered and 2 points for a good clock
3+ usually indicates a lower likelihood of dementia
What is the ascertain 8 questionnaire>
Screens for major and minor disorders with yes and no questions
2+ a cognition issue is likely to be present
If a cognition test is positive, what are the next steps that should be taken clinically?
Test for the degree of the cognitive decline
What are the cognitive tests that are used to test the degree of cognitive decline?
Mini-mental state examination
Montreal cognitive assessment (MOCA)
St Louis University mental status examination
What is the most common pathologic tremor?
Essential tremor
True or false alcohol can improve the symptoms of an essential tremor
True!
—————— includes difficulty rising from a seated position, reduced arm swing while walking, micrographia
Bradykinesia
Why is it important to get a family history regarding tremors running in the family?
Because some of them have genetic linkages
What disease is micrographia commonly seen in?
Parkinson’s
Micrographia is writing the letters super small
What is typically the first sign of a neurodegenerative disease?
A resting tremor is typically what brings people in for further evaluation
