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Clinical Medicine II-Spring 2012

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
How do we diagnose movement disorders   show
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Overall tx of a movement d/o   show
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Three classifications of abnl movement   show
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Dance like movement uncontrolled   show
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Twisting, rotational involuntary movement   show
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Myoclonic movement   show
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show upper Midwest, most per capita is in ND  
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show sustantia nigra: dopamine producing cells→by product is melonin linked to parkinson’s movements?  
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show skin cancer: melanoma  
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Cause of parkinson’s   show
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show ~70 at start of of sxs, slow onset, hard to dx sometimes  
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Core motor features of Parkinson’s   show
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Pt’s with simultaneous PD, dementia, and hallucinations   show
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show supranuclear palsy-no tremor  
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show can’t actually test for it, just r/o other causes, r/I by clinical sxs: give them a PD drug see if +result  
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What is the tx for PD   show
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SE’s of levodopa   show
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show need more meds, cells die, need more dopamine, sxs: tremors/can’t move, take pills, control, dyskinesia,then can’t move again  
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When do the motor complications of PD start   show
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show high frequency pulsatile, to “ablate” the overactive nerves, targets the nucleus (subthalamic)  
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When do we do the DBS to the brain   show
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What are some sxs that will precede the motor sxs of parkinsons   show
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Cause of death in pt’s w/ PD   show
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show Action or postural tremor or kinetic with tasks, can move to rest post action  
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Two most common places to see E.T.   show
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Secondary criteria for identifying E.T   show
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What can a “neck tremor” be   show
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show Genetic, Fhx, Dx: clinical hx, movement tremor,  
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Tx for E.T.   show
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Desire to move in association w/ paresthesias/dysethesias of the limbs   show
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show no it is most likely nocturnal myoclonus  
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Two types of RLS   show
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Pathophysiology of RLS   show
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Why does iron deficiency cause RLS   show
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show tx underlying dz, remove potential aggravators, ↑sleep hygiene, relaxation techniques, Dopamine agonists 1st line drug  
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Problem with shorter length drugs   show
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show usually only when there are other sxs with pain  
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Neurologic movement d/o w/ sustained muscle contractions that cause twisting or repetitive movements w/abnl sometimes painful, postures or positions   show
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show only sign, no specific pathology, DYT1 mutation inheritation  
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show from drugs, w/ parkinsonism, psychogenic causes  
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show focal, segmental, multifocal, generalized, hemidystonia  
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MC types of focal dystonia   show
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show botox, inject while in a flexed position, just enough to relax/paralysis the muscle good for focal  
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show r/o other causes  
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show blepharospasm  
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show Blepharospasm, cervical dystonia, writer’s cramp  
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show Babinski sign + for spasticity  
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What signs are associated w/ spasticity   show
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Tx of spasticity   show
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show ataxia, dysmetria of eye movements, nystagmus, dysarthria, limb dysmetria, gait ataxia  
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show dysarthria  
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When does ataxia occur   show
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Workup of ataxia   show
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show toxins, paraneoplastic cerebellar syndrome, sporadic cerebellar degeneration or hereditary  
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show supportive, assistive devices  
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show Huntinton’s disease  
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Dx and patho of HD   show
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show age 30-40, survival about 15-20yo  
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Tx HD   show
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What is the genetic testing for HD   show
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