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Neurologic System (NCCPA outline) questions with correct answers
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Neurologic System (NCCPA outline) questions with correct answers
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Neurologic System (NCCPA outline) questions withcorrect answers
What is the genetic basis of Huntington disease? CORRECT ANSWER Expansion
of the *c*ytosine-
*a*denine-
*g*uanine trinucleotide repeats in the HTT gene
think: you *HUNT* and animals go in a *CAG*e
PE will show pain in V2 and V3 distributions, not V1 CORRECT ANSWER Trigeminal Neuralgia
(Tic douloureux)
CT scan of someone with Huntington will reveal CORRECT ANSWER cerebral and caudate nucleus atrophy
PET scan in someone with Huntington disease CORRECT ANSWER decreased glucose
metabolism in caudate nucleus and putamen
- Patient will be a 30 - 50-years-old
- With a history of a family member with similar symptoms
- Complaining of gradual chorea and dementia
- Diagnosis is made by genetic testing - Most commonly caused by autosomal dominant *CAG trinucleotide repeats* CORRECT ANSWER Huntington Disease
- Patient will be complaining of rigidity, bradykinesia, postural instability, micrographia
- PE will show a resting pill-rolling tremor, mask-like facies, cog wheeling of extremities, shuffling gait
- Most commonly caused by dopamine depletion in basal ganglia
- Treatment is levodopa-carbidopa CORRECT ANSWER Parkinson's Disease
what is a cytoplasmic inclusion? CORRECT ANSWER Lewy body
- glycogen
- A/W Parkinsons and Lewy Body Dementia
Parkinson disease pathophys CORRECT ANSWER idiopathic *dopamine depletion* [from loss of pigment cells in substantial nigra] leads to *failure to inhibit acetylcholine* in the *basal ganglia* [what causes the movement d.o]
- a/w Lewy bodies (cytoplasmic inclusions) - *loss of pigment cells seen in the SUBSTANTIA NIGRA*
loss of pigment cells in substantial nigra CORRECT ANSWER parkinson
Which comorbid psychiatric condition is usually a medication side effect in patient
with Parkinson's disease? CORRECT ANSWER Answer: Psychosis, related to the "pro-dopamine" or dopamine-agonism convention used in treating Parkinson's disease.
Drug treatments for Parkinson CORRECT ANSWER Extrapyramidal Symptoms
- what causes it?
- what are EPS?
- how do you treat them? CORRECT ANSWER 1. Typical > atypical antipsychotics
--- Acute dystonia: muscle spasms, stiffness, oculogyric crisis, rx: *benztropine, dyphenhydramine*
--- Akathisia: restlessness, rx: *benztropine*, Bs
--- Bradykinesia: Parkinsonism, rx: *benztropine*
--- Tardive dyskinesia: orofacial involuntary movements
- necrosis of both upper and lower motor neruons
1. muscle weakness, loss of ability to initiate and control motor movements
2. mixed upper and lower motor neuron signs - UMN: spasticity, stiffness, hyperreflexia
- LMN: progressive bilateral fasiculations, muscle atrophy, hyporeflexia, muscle weakness. 3. Bulbar symptoms: dysphagia, dysarthria, speech problems, respiratory dysfunction
4. *Sensation, urinary and voluntary eye movements are SPARED* CORRECT ANSWER Amyotrophic Lateral Sclerosis
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