Pathology

Question 0

Parkinson’s disease symptoms

Answer 0

Pill rolling tremor
Akinesia
Bradykinesia 
Lead pipe rigidity 
Hypertonia
Fatigue
Sleep disorders - violent dreams 
Sweating 
Constipation

Question 1

Parkinson’s disease pathology

Answer 1

Death of dopaminergic cells in pars compacta of the substantia nigra
Prevents feedback loop of the basal ganglia
Loss of control over movement and some involuntary movement

Question 2

Huntington’s pathology

Answer 2

Autosomal dominant condition
Htt protein gets CAG repeats
Gain of toxic function
Damage is originally in the striatum

Question 3

Huntington’s symptoms

Answer 3

Loss of control over movement - Huntington’s chorea
Altered mood
Loss of higher cognitive functions

Question 4

Myasthenia gravis pathology

Answer 4

IgG mediated blocking of the end plate ACh receptor

Question 5

Myasthenia gravis symptoms

Answer 5

Fluctuating, fatiguable weakness of skeletal muscles
Extraoccular muscles often first
Progresses to limb weakness
Bulbar involvement causes dysphagia, dysphonia, dysarthria
Respiratory muscle involvement
Can have acute crises

Question 6

Drugs exacerbating myasthenia gravis

Answer 6

Aminoglycosides
Beta blockers
CCBs
Quinidine 
Procainamide 
Succinylcholine 
Chloroquinine, penicillamine 
Mg
ACE inhibitors

Question 7

Causes of cerebellar dysfunction

Answer 7

Tumour
Cerebrovascular disease
Genetic - eg Friedrich’s ataxia

Question 8

Cerebellar signs

Answer 8

Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Speech - scanning or slurred 
Hypotonia

Question 9

Upper motor neurone signs

Answer 9

Lesion above anterior horn cell
Hyper reflexia, hypertonia, positive Babinski sign - loss of descending inhibition
Clonus, spastic paralysis, cog wheel/lead pipe, choreoforms

Question 10

Decerebrate

Answer 10

No reaction to pain
Worse than decorticate
Total loss of rubrospinal tract

Question 11

Decorticate

Answer 11

No localisation of pain

But still a reaction

Question 12

Lower motor neurone signs

Answer 12

(If upper and lower occur together, presents as lower) 
Muscle weakness 
Hypotonia
Muscle atrophy
Hypo/areflexia
Fasciculations

Question 13

Bladder lower motor neurone lesion

Answer 13

Loss of stretch reflex

Overflow incontinence

Question 14

Bladder upper motor neurone lesion

Answer 14

Loss of coordination of input
Void as soon as stretch reflex is activated
Void incompletely

Question 15

What is dementia?

Answer 15

Acquired loss of cognitive ability sufficiently severe to interfere with everyday function and quality of life.
Untreatable and progressive
Loss of intellect, personality and behaviour
Due to loss of neurones or loss of communication between neurones

Question 16

Causes of dementia

Answer 16

Age related
Infective - CJD, HIV, viral encephalitis
Metabolic - hepatic disease, thyroid disease, parathyroid disease, cushings
Nutritional - Wernicke-Korsakoff (thiamine), B12, folate
Huntington’s
Hydrocephalus
Trauma
Tumour
Chronic inflammatory - collagen vascular disease, vasculitis, MS

Question 17

Alzheimer’s disease

Answer 17

Main age related dementia
Symptoms of slowly progressive mental degradation
2:1 female
Duration usually about 5 years, some live up to 20.
Terminal phase - near complete or complete loss of memory, speech and continence

Question 18

Pick disease

Answer 18

Age related dementia
Frontal or temporal lobe 
Personality/behavioural changes
Difficulty relating to others
Difficulty organising everyday activities 
Understanding and fluency of language

Question 19

Cortical dementia

Answer 19

Results in global type personality changes

Complex disabilities

Question 20

Subcortical dementias

Answer 20

Slowness and forgetfulness
Changes in movement
Increased muscle tone

Question 21

Savant syndrome

Answer 21

Severely autistic people

Have one or more areas of expertise which don’t correspond with their overall neurological limitations