Unit 3: Movement Disorders Flashcards
L1: “Ka” speech evaluates CN __.
X
L1: “La” speech evaluates CN __.
XII
L1: “Pa” speech evaluates CN __.
VII
L1: Which Parkinson’s therapeutic agent? Blocks decarboxylase, does not cross blood-brain barrier
Carbidopa
L1: Which pathologic pattern? Brief, intermittent movements or sounds, varying in intensity and repeated at irregular intervals
Tics
L1: Which pathologic pattern? Chorea-athetosis, dementia, and psychiatric illness
Huntington Disease
L1: Which pathologic pattern? Gross atrophy of caudate nucleus due to loss of medium spiny neurons
Huntington Disease
L1: Which pathologic pattern? Hereditary ataxia with limb ataxia, dysarthria, loss of distal position/vibration sense, areflexia, lower extremity UMN signs
Friedreich’s Ataxia
L1: Which pathologic pattern? Motor and vocal tics, poor impulse control, associated with OCD and ADHD
Tourette Syndrome
L1: Which pathologic pattern? Motor seizures, psychosis and personality disorders from temporal lobe involvement
Complex seizures
L1: Which pathologic pattern? Resting tremor, typically non-disabling and unilateral, rigidity, bradykinesia
Parkinson Disease
L2: Neuroleptic dopamine receptor antagonist used in Huntington disease
Haloperidol
L2: Positive findings (intention tremor) in the finger-nose-finger test or heel-shin test indicate ______.
dysmetria
L2: Pronator drift positivity indicates ________.
UMN syndrome: ipsilateral cerebellum/contralateral cortex
L2: What is the histologic pattern associated with Huntington Disease?
Caudate atrophy/gliosis
L2: What is the histologic pattern associated with Parkinson’s Disease?
Lewy Bodies and Lewy neurites in neuron processes
L2: What is the histologic pattern associated with Wilson’s disease?
Copper deposits in the putamen and globus pallidus
L2: Which gait disorder? Dragging toes, tightness of hip flexors that can result in midline crossing/scissored gait
Diplegic gait
L2: Which gait disorder? Foot drop, attempt to lift foot high enough such that it does not drag
Neuropathic gait
L2: Which gait disorder? Irregular jerky involuntary movements in all extremities, dancing/prancing
Choreiform gait
L2: Which gait disorder? Loss of proprioceptive input from feet, patient slams foot into ground to know when it contacts the ground
Sensory gait
L2: Which gait disorder? Patient holds flexed/adducted/internally rotated arm to side and circumducts foot
Hemiparetic gait
L2: Which gait disorder? Rigidity, bradykinesia, slow little steps, difficulty initiating steps
Bradykinetic/Parkinsonian gait
L2: Which gait disorder? Seen in biventricular lesions like cerebral palsy
Diplegic gait
L2: Which gait disorder? Spasticity in lower extremity with abnormally narrow base
Diplegic gait
L2: Which gait disorder? Staggering clumsy movements with wide-based gait, inability to walk heel to toe or in a straight line
Ataxic gait
L2: Which gait disorder? Stooped posture with neck forward and flexion at knees
Bradykinetic/Parkinsonian gait
L2: Which gait disorder? Unilateral or bilateral weakness that leads to drop of pelvis and waddling if bilateral
Myopathic gait
L2: Which gait disorder? Unilateral UMN injury resulting in plantar flexion and leg extension on affected side
Hemiparetic gait
L2: Which movement or psychiatric disorder can be elicited from the following treatment? Anti-psychotics
Parkinsonism
L2: Which Parkinson’s therapeutic agent? Decreases cholinergic inhibitory interneuron activity in the striatum
Anticholinergic agents
L2: Which Parkinson’s therapeutic agent? Increases endogenous release of dopamine, may work as glutamate receptor antagonist
Amantadine
L2: Which Parkinson’s therapeutic agent? Not as effective as L-DOPA, side effects parasympathetic block peripherally
Anticholinergic agents
L2: Which Parkinson’s therapeutic agent? Prevents breakdown of dopamine, can cause dangerous episodes of hypertension following NOR release
Monoamine oxidase inhibitors
L2: Which Parkinson’s therapeutic agent? Prevents breakdown of L-DOPA by COMT
Catechol-o-methyltransferase inhibitors
L2: Which Parkinson’s therapeutic agent? Used to smoothen the short half-life of L-DOPA and decrease dyskinesia
Dopamine Receptor Agonists
L2: Which pathologic pattern? Active opposition of any passive movement despite instruction to relax
Gegenhalten/paratonia
L2: Which pathologic pattern? Bilateral and disabling tremor (often postural) most commonly affecting the hands
Essential Tremor
L2: Which pathologic pattern? Co-contration of muscle agonists and antagonists, twisting abnormal postures resulting from sustained muscle contractions
Dystonia
L2: Which pathologic pattern? Exaggerated startle
hyperekplexia
L2: Which pathologic pattern? Glial alpha-synuclein inclusions
Multiple Systems Atrophy
L2: Which pathologic pattern? HANDS Tremor signs
Cerebellar extra-pyramidal signs
L2: Which pathologic pattern? Irregular, brief, dancing-like jerky movements
Chorea
L2: Which pathologic pattern? Large amplitude proximal flinging movements
ballism
L2: Which pathologic pattern? Localized quivering of few muscle bundles
myokymia
L2: Which pathologic pattern? Neuronal alpha-synuclein inclusions
Parkinson Disease, Diffuse Lewy Body Disease
L2: Which pathologic pattern? Repeated or ritualistic movement or utterance
stereotypy
L2: Which pathologic pattern? Repetitive involuntary, slow sinuous writhing movements
Chorea-athetosis
L2: Which pathologic pattern? Sudden brief shock-like movements
myoclonus
L2: Which pathologic pattern? Tremor, hypokinetic signs, hyperkinetic signs, dystonia
Basal ganglia extra-pyramidal signs
L2: Which pathologic pattern? Unpleasant sensation of inner restlessness (inability to remain motionless)
akathisia
L2: Which tests are used to evaluate for dysmetria?
Finger-nose-finger, Heel-shin
L2: Which pathologic pattern? Wing-beating tremor (basal ganglia degeneration), depression, exhibitionism, psychosis
Wilson Disease
L3: Name the three components of Multiple System Atrophy
Striatonigral degeneration, olivopontocerebellar atrophy, intermediolateral column degeneration
L3: Treatment for Essential Tremor (2)
Primidone, Propranolol
L3: Treatment for Tourette Syndrome or Huntington Disease (2)
Tetrabenazine, neuroleptics (dopamine receptor antagonists)
L3: What is the histologic pattern associated with ataxias?
atrophy of cerebellar folia, loss of Purkinje cells
L3: What is the histologic pattern associated with Corticobasal Degeneration?
Tau-immunoreactive inclusions, cerebral cortical atrophy
L3: What is the histologic pattern associated with Diffuse Lewy Body Disease?
Lewy bodies diffusely distributed, neuritic plaques and neurofibrillary tangles
L3: What is the histologic pattern associated with Multiple Systems Atrophy?
Glial alpha-synuclein inclusions distributed broadly
L3: What is the histologic pattern associated with Progressive Supranuclear Palsy?
Neurofibrillary tangles in neurons, tau-immunoreactive glia (especially in the basal ganglia)
L3: Which movement or psychiatric disorder can be elicited from the following treatment? L-DOPA/Parkinson’s therapeutics
Hallucinations, delusions, erratic behaviors
L3: Which Parkinson’s therapeutic agent? Anticholinergic agents (3)
Diphenhydramine, Trihexyphenidyl, benztropine
L3: Which Parkinson’s therapeutic agent? COMT inhibitors (2)
tolcapone, entacapone
L3: Which Parkinson’s therapeutic agent? Monoamine oxidase inhibitors (2)
rasagiline, selegiline
L3: Which pathologic pattern? Classified as tauopathies (3)
Dementing diseases, Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD)
L3: Which pathologic pattern? Synucleinopathies involving Lewy bodies (3)
Parkinson Disease, Diffuse Lewy Body Disease, Multiple Systems Atrophy
L4: Which Parkinson’s therapeutic agent? Dopamine Receptor Agonists (5)
Pergolide, cabergoline, ropinerole, pramipexole, bromocriptine
L4: Which pathologic pattern? Disorders presenting with parkinsonism and substantia nigra disorder (5)
Parkinson Disease, Multiple System Atrophy, Progressive supranuclear palsy (PSP), Pick Disease, Corticobasal degeneration
