W04_01 Hypokinetic movement disorders

Question 1

definition of parkinsonism?

Answer 1

bradykinesia, plus one of:

• rigidity,
• tremor,
• postural instability (unrelated to visual/vestibular/cerebellar dysfunction)

Question 2

which abnormality of the hand is an early sign of PD?

Answer 2

flexion @ MCP,

extension @ digits

Question 3

these are required for diagnosing PD:

Answer 3

at least 3 of:
unilateral/asymmetric onset
persistent asymmetry
great response to L-DOPA
long-term response to L-DOPA
L-DOPA induced chorea
rest tremor
progressive
long term course

Question 4

pathologic associations of PD?

Answer 4

loss of dopaminergic neurons of subtantia nigra pars compacta;
overabundance of eosinophilic lewy bodies

Question 5

most common genetic mutation of PD?

Answer 5

LRRK 2 mutation;

Parkin mutation

Question 6

multiple system atrophy includes these symptoms

Answer 6

BPH or bladder problems;
postural instability;
orthostatic hypotension;
symmetric rigidity;
anterocollis;
stridor;
swallowing difficulty

Question 7

imaging characteristics of MSA?

Answer 7

hypointense posterior putamen in T2;

hyperintense hot cross bun on pons in T2

Question 8

progressive supranuclear palsy symptoms?

Answer 8

hard to move eyes, especially down (but can move by VOR);
postural instability;
symmetric bradykinesia;
swallowing/speaking issues;
axial rigidity;

Question 9

progressive supranuclear palsy imaging signs?

Answer 9

atrophy midbrain (hummingbird sign)

Question 10

typical sign of corticobasal degeneration?

Answer 10

limb/hand curls up and twitches. forget how to use the hand (apraxia). hand moves on its own (alien limb syndrome)

Question 11

name a few types of atypical parinsonisms

Answer 11

MSA,
PSP,
CBD,
Wilson’s disease

Question 12

name examples of drugs that can cause parkinsonism

Answer 12

antipsychotics,

lithium