Term
| What is the Direct and indirect path through the basal ganglia from the cortex |
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Definition
Direct: Layer V of Cortex(+)->Striatum(-)-> GPI(-)->Thalamus(+)->Cortex(Intiating Action)
Indirect: Cortex(+)->Striatum(-)->GPE(-)-> SubthalamicNucleus(+)->GPI(-)->Thalamus(+)->Cortex(Blocking Action) |
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Term
| What are the affects of parkinson's disease on the pathways through the basal ganglia |
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Definition
Direct pathway: Decreases inhibition of GPI leading to more inhibiton of the thalamus causing decreased initiation of Action
Indirect pathway: Increases Inhibition of GPE causing more inhibition of the Subthalamic Nuclei and less activation of the Thalamus leading to less initiation of action |
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Term
|
Definition
| Reduced ouput from the caudate and the putamen to the GPe |
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Term
| What are some common causes of chorea |
|
Definition
Hereditary: Huntington's, Neuroacanthosis, Wilson's Disease
Infectious: Sydenham's, SLE, Excephalitis
Drugs: Dopa, Antipsychoatic
Metabolic: Chorea Gravidarum, Hyperthyroid, HONK
Vascular: stroke |
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Term
| What is the pathology of huntington's disease |
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Definition
| Loss of GABAnergic neurons in the Caudate nucleus |
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Term
| What are some common psychopathic symptoms of huntington's disease and what is the typical age of onset? |
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Definition
Age of Onset: 35-40 years old
Psychopath:
Dementia
Personality Changes
Chorea
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|
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Term
| What is the appearance of Huntington's disease on MRI |
|
Definition
| Flattened caudate nucleus with larger appearing lateral ventricles |
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Term
| What is the inheritance and mutation type of wilson's disease and huntington's disease |
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Definition
Wilson's: AR mutation in copper metabolism
Huntington's: AD CAG trinucleotide repeats(Anticipation) |
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Term
| How does wilson's disease typically present |
|
Definition
Motor:
Proximal Tremor
Incoordination,
Gait problems
Somatic:
Hepatic Failure
Behavioral:
Agressive
Compulsive
Depressed |
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Term
| How do you diagnose Wilson's disease |
|
Definition
KF ring(In Descemet's Membrane)
24hr Urine Copper
Serum Ceruloplasm |
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Term
| What is the treatment of wilson's disease |
|
Definition
| Chelation with Zinc, Penicillamine, Trientine |
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Term
| What are females who experienced sydneanms chorea as a child more likely to exhibit in adulthood? |
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Definition
|
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Term
| What is the cause of sydenam's chorea? |
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Definition
| Cause: Ab to Group A strep |
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Term
| What is the pathology of Hemiballism and how does it present? |
|
Definition
| lesion to the subthalamic nucleus decreasing activation of the GPi |
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Term
| What is the most common cause of Myoclonus seen in hospital patients and how do you treat myoclonus |
|
Definition
Metabolic disease
Treatment:Benzodiazepines, Valproate |
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Term
| What is the presentation of essential tremor |
|
Definition
| Rhythmic back and forth motions possibly in voice as well |
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Term
| What are the treatment options for essential tremor |
|
Definition
B-blok
Primidone
Topiramate
Treatment may not be necessary |
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Term
| What is the most common cause of childhood dystonia |
|
Definition
| Autodominant DYT1 mutation |
|
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Term
| What is the first treatment option you should try in a dystonic patient |
|
Definition
|
|
Term
| What are the drugs causing dystonia |
|
Definition
|
|
Term
| How do you treat dystonia |
|
Definition
Anticholinergics
Baclofen
Benzos
Botox for facial dystonia |
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|
Term
| What is the most common secondary tic etiology |
|
Definition
|
|
Term
|
Definition
DA blockers
Clonidine
Clonazepam |
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|
Term
| What is the presentation of parkinson's |
|
Definition
Rest tremor
Rigidity
Bradykinesis
Freezing
Facial grimacing
Problems intiating movement
Dementia
Depression |
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Term
| What is the rate limiting step of dopamine synthesis and enzymes that break it down |
|
Definition
Tyrosine Hydroxylase
MAO
COMT |
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Term
| Which dopamine receptors are excitatory and which are inhibitory |
|
Definition
Excitatory: D1 and D5
Inhibitory: D2, D3, D4 |
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Term
| What are the treatment options for Parkinson's |
|
Definition
L-dopa and Carbidopa
DA's
MAO-B blockers or COMT inhibitors
Anticholinergics
Amantidine
Deep Brain Stim
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|
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Term
| What are the parkinson's plus diseases, what are some key features, and do these diseases respond to sinemet |
|
Definition
Cortico-Basal Ganglionic Degeneration:
Alein Hand
Apraxia
Aphasia
Progressive Supranuclear Palsy(steele-richardson syndrome):
Axial rigidity
Loss of Balance
Supranuclear Ophthalmoplegia
Multisystem Atrophy:
Autonomic Failure
Ataxia
Diffuse Lewy Body:
Hallucinations
Cognitive Fluctuations
Dementia
*No response to Sinemet |
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Term
| What is Chorea and Athetosis |
|
Definition
Chorea: Continuous, Rapid, Jerky
Athetosis: Writhering, Sinusoidal |
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|
Term
| What psych disorders are associated with Tourette's |
|
Definition
|
|
Term
|
Definition
Neuroleptics
Clonidine
Benzos |
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