T9.5: Movement Disorders - Basal Ganglia Flashcards
A man moves his hand to clear hair from his face. Which describes the correct series of events?
A.Cortex excites striatum, inhibiting the GPI, releasing the subthalamus to excite the thalamus
B.Cortex excites striatum, excites the GPI, releasing the thalamus
C.Cortex inhibits striatum, inhibiting GPI, releasing the thalamus.
D.Cortex excites striatum, inhibits GPE, releasing subthalamus which excites the GPI inhibiting the thalamus.
E.Cortex excites striatum, exciting the GPE, releasing the subthalamus exciting the thalamus
F. Cortex excites striatum, inhibits GPI, releasing the thalamus
RFA
Ans. F Is the the Direct pathway which facilitates movement
D. - the indirect pathway (diminishing movement pathway)
A 57 year old man suffers comes to the doctor. During examination he shows short strides and a resting tremor. Which is true of this man’s condition?
A. Alters activity in the direct and indirect pathway B. Thalamic inhibition is decreased C. Increased inhibition of the GPI D. Treat with drugs that deactivate D1 E. Lewy bodies degenerated.
RFA
Ans. A - The Patient is suffering from Parkinson’s a disease that root cause is do to insufficient dopamine release. This affects both the direct and indirect pathways but has a more marked effect on the direct pathway since the low dopamine decreases the inhibition of the GPI not allowing it to release the Thalamus for movement.
B. Thalamic inhibition would be increased
C. There would decreased GPI inhibition
D. Parkinson’s can be treated Agonist of D1(direct pathway) and D2 (indirect Pathway) or Anticholinergic drugs that inhibit D2
E. Lewy bodies are formed from Alpha synucleins during Parkinson’s
A 41 year old male patient comes into the clinic he has been suffering from depression. A CT is done and it is noticed that the patient has enlarged ventricles. Which treatment would be appropriate for this patient?
A.MAO inhibitors B. Antiviral therapy C.COMT inhibitors D. Deep brain stimulation E. VMAT inhibitor F. Carbidopa
RFA
ANS.E VMAT inhibitor- is a dopamine depleting agent that helps to reduces hyperkinesis
The patient has Huntington’s Disease as supported by the presence of depression and enlarged ventricles
Other treatments of Huntington’s noted are Antidepressants and D2 receptor antagonist
All the other choices are treatments for Parkinson’s
A. MAO inhibitors & C. COMT inhibitor dopamine metabolism
B. Antiviral therapy -may promote the release of dopamine
D. Deep brain stimulation- stimulation of Thalamus, GP or Subthalamus may help Parkinson’s
F. Carbidopa- reduces the peripheral metabolism of L-dopa.
You walk into the ER and there is loud screaming and you witness a security guard get hit in the head by a patient who’s right side of the body is flailing and spinning. Which of the following is damaged?
A) RIGHT Str B) RIGHT GPe C) RIGHT GPi D) RIGHT Sth E) LEFT Str F) LEFT GPe G) LEFT GPi H) LEFT Sth
answer H - hemiballismus is caused by dmg to contra laterally sub thalamus
Your are examining your patient with striatal injury. which of the following symptoms is he most likely to develop?
A) Athetosis B) Rigidity C) Akinesia D) Resting Tremor E) Bradykinesia
Answer = A . Athetosis is slow involuntary continuous writing which can be from a striatal injury.
all other symptoms are hypo kinetic or symptoms of Parkinson’s
You schizophrenic patient who is being treated for his craziness presents to the hospital with trouble walking normally and rigidity. You see him coming to the exam room with short strides. What is the mechanism causing his problems?
A) Depletion of Dopamine stores B) Viral Encephalitis C) Dopamine Receptor Blocker D) Toxic MPTP E) He is Mike Tyson
ANSWER - C b/c he is on antipsychotics which act as dopamine receptor blockers and can give parkinsonian conditions
ALL OTHER CAN GIVE THE SYMPTOMS TOO
A) Depletion of Dopamine stores - RESERPINE
B) Viral Encephalitis - NIGRAL DEGENERATION
C) Dopamine Receptor Blocker - ANTIPYSCHS
D) Toxic MPTP - JUST CUZ
E) He is Mike Tyson - TRAUMA TO HEAD
