Parkinson's Disease and Syndromes Quiz

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Questions and Answers

What is a common cause of epidural bleeding?

  • Surgical complications
  • Tear in middle meningeal artery (correct)
  • Tear in bridging veins
  • Rupture of cranial arteries

Which of the following features is characteristic of subdural bleeding?

  • Lucid interval without deterioration
  • Rapid accumulation of blood (correct)
  • Commonly caused by arterial tears
  • Gradual increase in consciousness

What is the typical mortality rate associated with subdural bleeding?

  • 40-50%
  • 10-15%
  • 50-80% (correct)
  • 20-30%

Which symptom is considered the most reliable indicator of a concussion?

<p>Retrograde/anterograde amnesia (C)</p> Signup and view all the answers

What is the main treatment method for resolving a subdural hematoma?

<p>Neurosurgical evacuation (A)</p> Signup and view all the answers

Which condition is characterized by rhythmic, uniphasic contractions without spreading?

<p>Epilepsia partialis continua (C)</p> Signup and view all the answers

What describes asterixis in terms of muscle activity?

<p>Lapses in sustained posture causing involuntary movements (D)</p> Signup and view all the answers

Which movement disorder involves the involuntary contraction of eyelid muscles?

<p>Blepharospasm (A)</p> Signup and view all the answers

What is the primary characteristic of polymyoclonus?

<p>Widespread, lightning-like a rhythmic contractions (B)</p> Signup and view all the answers

What best describes Meige’s syndrome?

<p>Forceful jaw opening with facial spasms (C)</p> Signup and view all the answers

What is a common symptom of an MCA stroke when the dominant hemisphere is affected?

<p>Global aphasia (A)</p> Signup and view all the answers

Which symptom is characteristic of a PCA stroke?

<p>Hemisensory deficit (C)</p> Signup and view all the answers

What effect does damage to the optic tract have on visual fields?

<p>Contralateral homonymous hemianopia (C)</p> Signup and view all the answers

What is the gold standard treatment for acute ischemic stroke?

<p>Intravenous recombinant tissue plasminogen activator (rt-PA) (D)</p> Signup and view all the answers

Which symptom is typically spared in an ACA stroke affecting the motor regions?

<p>Leg movement (B)</p> Signup and view all the answers

What is a common symptom associated with neglect syndrome?

<p>Failure to respond to stimuli on one side of the body (C)</p> Signup and view all the answers

What is the primary benefit of using anticoagulation therapy in patients with atrial fibrillation?

<p>To reduce the risk of stroke (C)</p> Signup and view all the answers

Which of the following is a component of Horner's syndrome?

<p>Miosis (A)</p> Signup and view all the answers

Which of the following represents a management step for stroke patients?

<p>Correct hyperglycemia gradually (A)</p> Signup and view all the answers

Which modality is directly involved in the rehabilitation of neurospasticity?

<p>Daily stretching and static resting splints (D)</p> Signup and view all the answers

In the context of traumatic spinal cord injuries, what characterizes Brown-Sequard syndrome?

<p>Complete loss of motor and sensory function on one side of the body (D)</p> Signup and view all the answers

Which intervention is most appropriate for treating aphasia?

<p>Visual action therapy (D)</p> Signup and view all the answers

What is a common consideration in the rehabilitation of stroke patients related to their vital signs?

<p>Best rehabilitation occurs when blood pressure and vital signs are stabilized (A)</p> Signup and view all the answers

Which complication is associated with neuroleptic drugs?

<p>Tardive dyskinesia (D)</p> Signup and view all the answers

What is the primary cause of traumatic brain injury (TBI) in adults?

<p>Alcohol abuse (B)</p> Signup and view all the answers

What characterizes a closed head injury?

<p>Blunt non-penetrating injury (C)</p> Signup and view all the answers

Which type of brain injury likely leads to generalized mass effect in the brain?

<p>Diffuse axonal injury (C)</p> Signup and view all the answers

Which site of hemorrhage results in extreme headache and vomiting?

<p>Subarachnoid hemorrhage (D)</p> Signup and view all the answers

What type of injury is associated with the atlanto-axial dislocation?

<p>Whip splash injury (A)</p> Signup and view all the answers

What can occur as a result of a basal skull fracture?

<p>Anosmia (C)</p> Signup and view all the answers

Which statement about secondary traumatic brain injury (TBI) is true?

<p>It is triggered by initial physiological processes. (C)</p> Signup and view all the answers

What is the primary role of the Circle of Willis in the brain's vascular system?

<p>Providing collateral circulation (C)</p> Signup and view all the answers

Which condition is characterized by occlusion due to atherosclerotic plaque?

<p>Thrombosis (C)</p> Signup and view all the answers

What are the primary components of the vertebrobasilar territory?

<p>Basilar artery and PICA (A)</p> Signup and view all the answers

What is a potential consequence of bilateral blockage in the carotid artery?

<p>Diffuse global ischemia (D)</p> Signup and view all the answers

Which type of stroke involves blood from a weak heart after an acute myocardial infarction?

<p>Embolic stroke (D)</p> Signup and view all the answers

What is the most common location for an intracerebral hemorrhage?

<p>Putamen (A)</p> Signup and view all the answers

What type of aneurysm is characterized by a bulging outpouching of a blood vessel?

<p>Saccular aneurysm (C)</p> Signup and view all the answers

What are the potential outcomes of an abnormal connection between arteries and veins known as an AVM?

<p>Mixing of oxygenated and deoxygenated blood (A)</p> Signup and view all the answers

Flashcards

Clonus

A series of rhythmic, uniphasic muscle contractions and relaxations.

Epilepsia partialis continua

A type of clonus, with rhythmic monophasic muscle contractions that don't spread.

Myoclonus

Arrhythmic, shock-like muscle contractions, brief and asynchronous.

Polymyoclonus

Widespread, rhythmic muscle contractions in many parts of the body.

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Asterixis

Arrhythmic loss of sustained posture, muscles relax, allowing movement.

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Blepharospasm

Involuntary blinking or spasms of the eyelid muscles.

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Myokymia

Involuntary contractions of the lower eyelid muscles.

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Meige's Syndrome

Forceful jaw opening with spasms of eyelid and facial muscles.

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Spasmodic torticollis

Neck muscle spasms causing head rotation and retraction.

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Writer's Cramp

Hand and forearm muscle spasms during skilled motor acts (like writing).

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Craniotomy

Surgical opening of the skull.

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Epidural Hematoma

Bleeding between the dura and skull, commonly due to temporal bone fracture.

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Epidural Hematoma Symptoms

Sudden loss of consciousness (LOC), potential lucid interval (brief recovery) and increasing ICP.

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Epidural Hematoma Prognosis

High risk of cardiorespiratory arrest and 20% mortality.

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Subdural Hematoma

Bleeding in the subdural space (between dura and brain), often due to bridging vein rupture.

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Subdural Hematoma Symptoms

Rapid LOC, rapid deterioration, possibly lucid interval, herniation potential, increased ICP.

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Chronic Subdural Hematoma

Blood or CSF collection, frequent in elderly or alcoholics.

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Cerebral Concussion

Reversible, traumatic nervous system paralysis from a blow to the head, mild possible loss of consciousness.

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Cerebral Concussion Symptoms

Signs might include acceleration/deceleration forces, brief bradycardia, and amnesia(most reliable indicator).

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Carotid Territory

The brain region supplied by the carotid arteries.

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Vertebrobasilar Territory

The brain region supplied by the vertebrobasilar arteries.

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Circle of Willis

A network of arteries in the brain providing collateral circulation.

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Collateral Circulation

Alternative pathways for blood to reach the brain if a main artery is blocked.

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Diffuse Global Ischemia

Brain damage due to complete blockage of blood supply to both sides of the brain.

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Ischemic Stroke

Stroke caused by reduced blood flow to the brain.

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Thrombosis

Ischemic stroke caused by a stationary blood clot (thrombus).

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Embolism

Ischemic stroke caused by a moving blood clot (embolus).

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Lacunar Infarct

Small stroke (<1.5cm) affecting subcortical areas.

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Hemorrhagic Stroke

Stroke caused by bleeding in the brain.

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Intracerebral Hemorrhage

Bleeding within the brain tissue.

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Subarachnoid Hemorrhage

Bleeding into the space around the brain.

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Aneurysm

A weakened blood vessel that bulges or balloons outwards.

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Cerebral Angiogram

An imaging technique to visualize blood vessels in the brain.

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Tourette Syndrome

A neurological disorder characterized by multiple motor and vocal tics, often including involuntary vocalizations and compulsive obscenities.

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Akathisia

A state of motor restlessness, often a side effect of neuroleptic drugs.

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Tardive Dyskinesia

Involuntary movements, particularly of the face, mouth, and tongue, caused by long-term use of neuroleptic drugs.

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Traumatic Brain Injury (TBI)

Damage to the brain caused by an external force.

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Demographics of TBI

Males are more likely to sustain TBI at all ages.

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Etiology of TBI

Alcohol abuse is a significant indirect cause of TBI.

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Primary TBI Injury

Damage to the brain occurring at the moment of impact. 

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Diffuse Axonal Injury (DAI)

Widespread stretching of axons, often caused by rapid brain rotation.

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Primary vs. Secondary TBI

Primary TBI is the initial damage at the time of impact. Secondary effects are subsequent damage due to the initial impact.

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Secondary TBI

Physiological and pathologic processes triggered by initial (primary) injury, leading to further damage.

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Closed Head Injury

Blunt trauma to the head without penetrating the skull.

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Open Head Injury

Injury where the skull is penetrated, leading directly to the brain.

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Skull Fracture Deficits

Damage to the skull can cause various neurological issues.

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Intracerebral Hemorrhage

Bleeding inside the brain.

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Subarachnoid Hemorrhage

Bleeding in the space between the arachnoid and pia mater.

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Subdural Hemorrhage

Bleeding between the dura and arachnoid mater.

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Epidural Hemorrhage

Bleeding between the skull and dura mater.

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Stroke Prevention

Strategies to reduce the likelihood of a first-time stroke.

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Aspirin for Stroke

Low-dose aspirin (160-300mg per day) used to prevent blood clots.

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Secondary Stroke Prevention

Measures taken to reduce the risk of recurrence after a stroke.

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Carotid Endarterectomy

Surgical procedure to remove plaque buildup in the carotid arteries.

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Cranial MRI

Imaging technique used to visualize the extent of brain injury in stroke.

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Neurospasticity

Muscle stiffness and uncontrolled movements after stroke.

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Botulinum Toxin Injection

Treatment to reduce muscle spasms and improve mobility in neurospasticity.

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Constraint-Induced Movement Therapy

Therapy to retrain the brain to use the affected limb.

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Body Weight Supported Treadmill Training (BWSTT)

Therapy using a treadmill to support the body weight.

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Best Rehab Time

Rehabilitation should start after blood pressure (BP) and vital signs (VS) are stabilized.

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Aphasia Treatment

Treatment focused on language and communication skills for patients with Aphasia.

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Percutaneous Endoscopic Gastrostomy

Procedure for inserting a feeding tube directly into the stomach.

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Bowel and Bladder Control

Strategies for managing bowel and bladder function after stroke.

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Deep Vein Thrombosis (DVT)

Blood clot in a deep vein, often in the legs.

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Anti-embolic Stockings

Compression stockings to prevent DVT by promoting blood circulation.

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Transverse Myelopathy

Complete sensorimotor myelopathy affecting ascending and descending tracts.

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Combined Painful Radicular and Transverse Cord Syndrome

A neurological condition combining pain and spinal cord dysfunction.

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Brown-Sequard Syndrome

Hemicord syndrome affecting one side of the spinal cord, causing sensory and motor issues.

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Ventral Cord Syndrome

Injury to the anterior column of the spinal cord, sparing the posterior column.

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Spasticity

A condition characterized by increased muscle stiffness and tightness.

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Sensation

The ability to feel, such as touch, pain, and temperature.

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Aphasia

A language disorder affecting the ability to communicate.

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Apraxia

Difficulty performing purposeful movements, despite normal motor function.

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Neglect Syndrome

A condition where a person ignores a part of their visual field.

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Dysphagia

Difficulty swallowing.

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Inhibited B&B

Loss of bladder and bowel control due to neurological issues.

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MCA Stroke

Stroke affecting the middle cerebral artery.

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MCA Syndrome- Mainstem

Symptoms of a middle cerebral artery stroke affecting both sides of the body.

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MCA Syndrome- Upper Division

Stroke affecting upper part of middle cerebral artery, sparing the legs.

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MCA Syndrome- Lower Division

Stroke affecting lower part of middle cerebral artery, mainly ocular findings.

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Optic Nerve Lesion

Complete blindness in one eye.

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Optic Chiasm Lesion

Loss of half the visual field in each eye.

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Optic Tract Lesion

Loss of the contralateral visual field in each eye.

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Contralateral Homonymous Hemianopia

Blindness in the same half of the visual field in both eyes.

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ACA Stroke

Stroke affecting the anterior cerebral artery, usually sparing the hand.

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PCA Stroke

Stroke affecting the posterior cerebral artery, primarily affecting visual pathways.

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Wernicke Aphasia

Difficulty understanding and producing meaningful language.

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Affective Agnosia

Inability to recognize emotions.

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Golden Period for Stroke Management

The initial timeframe after a stroke where treatment is most effective to reduce neural damage.

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Cerebral Autoregulation

The brain's ability to maintain a constant blood supply.

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Cerebral Perfusion Rate

Blood flow to the brain.

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t-PA

Recombinant tissue plasminogen activator.

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Heparin

An anticoagulant that reduces blood clotting.

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Study Notes

Parkinson Syndrome

  • Primarily a deficit of akinesia (or hypokinesia)
  • Bradykinesia is evident as slow movement and reaction time delays
  • Rigidity is manifest as increased muscle tone
  • Tremor is typically 3-5 per second, affecting fingers, arms, and chin
  • Postural imbalance is commonly associated
  • Flexed posture, rounded shoulders, and slightly flexed arms/knees/legs are common
  • Disequilibrium and festination (quickening steps) are often observed

Parkinsonism

  • A drug-induced symptom
  • Dopamine depletion is characteristic
  • Drugs competing with dopamine can trigger parkinsonism
  • Symetry is a common feature, with tremor less frequently involved
  • Symptoms often appear after 3 months of drug intake
  • Haloperidol is a common drug associated with the disease

Parkinson's Disease

  • Synonymous with Paralysis Agitans
  • Neurodegenerative disorder of the extrapyramidal system
  • Characterized by resting tremor, rigidity, and bradykinesia
  • Typically an adult-onset condition
  • Idiopathic in origin
  • Treatment typically involves levodopa
  • Genetic factors can increase risk by seven times
  • Loss of pigmented cells in the substantia nigra is a key pathological finding
  • Dopamine loss, in particular, is a key feature

Diagnostic Criteria

  • Clinically probable Parkinsonism if one symptom is present: resting tremor, rigidity, or bradykinesia
  • Clinically probable if 2 symptoms are present
  • Clinically definite if 3 symptoms are present and at least 1 displays symmetry

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