Neurodegenerative disease Flashcards
A patient has been figiting for several years and starts to experience personality changes, jerky movements affecting the entire body, short term memory loss, etc. what is this?
Huntingtons
What is athetosis?
Writhing movements associated with chorea
What is the pathogenesis of hunting tons?
CAG repeat, inherited AD
Describe childhood hunting tons and how it is different from the adult variant
Called Westphal variant, more severe, looks more like Parkinson’s
Affects neostratium
What therapies are available for hunting tons?
Haldol, tetrabenzine to treat chorea
What factors are associated with increased frequency of AD?
age, female sex, history of severe trauma, down syndrome
Describe normal progression of AD
difficulty with personal tasks progresses to losing the ability to speak, think and make decisions
What are the pathologic features of AD?
brain atrophy, senile plaques,
What therapies are used for alzheimer’s disease?
treating associated symptoms (depression, agitation, sleep disorders), preventing progression (therapy with acetylcholinesterase inhibitors),
What are the criteria for diangosis of vascular dementia?
presence of dementia and focal neurologic signs on exam
A patient presents with a parkinsonian picture, visual hallucinations and extrapyramidal symptoms. This is…
dementia with lewy bodies
A patient presents with a failure of vertical gaze, dysarthria, dysphagia, gait ataxia and demenita. This is..
progressive supranuclear palsy
A patient presents with significant alteraion in personality, social behavior and language. Think…
frontotemporal dementia
What treatment is most effective for REM sleep behavior disorder?
clonazepam
An eldelry lady has been abusive to her neighbors, stealing their clothes. On exam, her pupils are small and only react when she is asked to look at her nose. This is..
neurosyphillis - reaction to accomodation but not light
A 58 year ol man with PMH of coronary artery bypass is having difficulty multi-tasking. This is…
hypoxic ischemic encephalopathy
A 50 year old man undergoes personality change over 3 months, becoming apathetic and disinterested. He has dysarthria, an exagerrated startle response. This is..
CJD
An elderly woman is afraid to be in the house alone, is hoarding and keeps getting lost on the way home. This is..
alzheimer’s - early signs are paranoia, etc.
An elderly man develops cognitive impairment involving memory and impacting his occupation and social functioning. This is..
dementia
What treatments are used for AD?
memantine - NMDA receptor antagonist; cholinesterase inhibitors (Exelon = riverstigmine) or Donezepil = Aricept
What therapies can be used to treat Parkinson’s?
Dopamine agonists, MAO Inhibitors, COMT inhibitors, anticholinergic, amantidine
What are common side effects if dopamine agonists?
Nausea, vomiting, hallucinations, sleep attacks, impulse disorders
What are common side effects of MAO inhibitors?
Nausea, headache, insomnia, malignant hypertension with sympathomimetics
What are the features of multiway stem atrophy?
Autonomic dysfunction, more rapid progression, more symmetric than PD
What is the classic radiologic sign if multisystem atrophy?
Hot cross bun sign
What are the features of progressive supra nuclear palsy?
Loss of vertical saccades, dysphagia, neck dystonia,
What is the classic radiogic features of PSP?
Hummingbird sign
What are the clinical features of cortical basal degeneration?
Alien lib, asymmetric Parkinson’s rigidity, cortical deficits, apraxia
A patient presents with CO poisoning. What area of the brain can be affected?
delayed necrosis of the globus pallidus may occur
A 30 year ol woman develops headaches, dilated pupils that are non reactive and an inability to look up. This is..
perinaud’s phenomenon affecting pineal gland
What area is typically ablated during Parkinson’s seizures?
subthalamic nucleus
