Week11

Questions and Answers

What type of tremor is most commonly associated with postural instability?

Essential tremor (correct)

Resting tremor

Cerebellar tremor

Action tremor

Which of the following conditions is NOT directly associated with hyperkinetic movements?

Parkinsonism (correct)

Tourette’s disorder

Wilson's disease

Huntington's disease

Which of the following best describes myoclonus?

Sudden lightning-like movement (correct)

Abrupt irregular body movement

Involuntary vocalizations

Repetitive abnormal postures

What is a common management strategy for tics in Tourette’s disorder?

Dopamine agonists Signup and view all the answers

Which type of dystonia might involve muscle contractions causing abnormal postures?

Focal dystonia Signup and view all the answers

What is the primary cause of Parkinson's disease?

Dopaminergic neuron damage Signup and view all the answers

What is the primary function of osteoblasts in bone remodeling?

Formation of new bone tissue Signup and view all the answers

Which condition leads to chaotic osteoclast function and increased bone remodeling?

Paget's disease Signup and view all the answers

What biological marker is notably elevated in Paget's disease and serves as a hallmark indication?

Alkaline phosphatase Signup and view all the answers

What is a common consequence associated with Vitamin D deficiency?

Increased fractures Signup and view all the answers

Which clinical feature is most indicative of Paget's disease?

Bowed lower extremities Signup and view all the answers

What is the primary use of the FRAX score?

Determining fracture risk Signup and view all the answers

Which of the following is a secondary condition that can lead to osteoporosis?

Chronic Renal Failure Signup and view all the answers

Which of the following is NOT a result of bone remodeling?

Osteoclast activation exclusively Signup and view all the answers

What immediate action should be taken for a patient with absent breath sounds and hemodynamic instability suspected of tension pneumothorax?

Insert a chest tube Signup and view all the answers

Which of the following statements about Osgood Schlatter disease is true?

It is common among jumpers and runners. Signup and view all the answers

Which factor is NOT indicative of a toddler's fracture?

Is a sign of child abuse Signup and view all the answers

What is a critical characteristic of flail segments in rib fractures?

They cause paradoxical motion of the chest wall. Signup and view all the answers

What is a primary management strategy for rib fractures?

Use of incentive spirometry and deep breathing exercises Signup and view all the answers

What are the consequences of high intrathoracic pressure due to tension pneumothorax?

Decreased venous return Signup and view all the answers

What is primarily affected by the accumulation of Lewy Bodies in Parkinson's Disease?

Substantia Nigra dopaminergic neurons Signup and view all the answers

Which feature is characteristic of Huntington's Disease?

Involuntary choreiform movements Signup and view all the answers

What clinical sign is commonly associated with Wilson's Disease?

Kayser-Fleischer rings Signup and view all the answers

Which physiological change results from the loss of striatal inhibitory output in Huntington's Disease?

Uncontrolled involuntary movements Signup and view all the answers

What is a common consequence of spinal cord transection?

Complete sensory loss below the lesion Signup and view all the answers

What is a key characteristic of Central Cord Syndrome?

Sparing of dorsal columns Signup and view all the answers

What is often increased in a 24-hour urine test for Wilson's Disease?

Copper levels Signup and view all the answers

Which of the following is a common management option for Wilson's Disease?

Penicillamine Signup and view all the answers

What brain structure undergoes pronounced atrophy in Huntington's Disease?

Caudate nucleus Signup and view all the answers

What unusual psychiatric risk is associated with Huntington's Disease?

Increased risk of suicide Signup and view all the answers

Which condition is characterized by cerebellar tonsils and medulla herniating through the foramen magnum?

Chiari Malformation Type 2 Signup and view all the answers

Which autoimmune disorder is associated with small cell lung carcinoma and presents with bulbar symptoms?

Lambert Eaton Myasthenic Syndrome Signup and view all the answers

What is the primary symptom of Carpal Tunnel Syndrome related to nerve compression?

Numbness in radial 3 and ½ digits Signup and view all the answers

Which of the following conditions results in anemia and weakness in the ulnar distribution due to over-abduction of the arm?

Klumpke's Palsy Signup and view all the answers

What diagnostic method is essential for the evaluation of Mononeuritis Multiplex?

Nerve Conduction Velocity (NCV) Signup and view all the answers

Which statement about osteoporosis screening in women is true?

Screening should include women under 65 with risk factors. Signup and view all the answers

What is a common characteristic of Fibromyalgia?

Chronic myofascial pain syndrome Signup and view all the answers

In the context of osteoporosis, what does a negative T-score indicate?

Higher risk of fracture Signup and view all the answers

What symptom is often NOT associated with Lambert Eaton Myasthenic Syndrome?

Sensory changes Signup and view all the answers

Which risk factor for osteoporosis is most critical during adolescence?

Pregnancy during adolescence Signup and view all the answers

What is the most common injured ligament in the ankle due to inversion and plantar flexion?

Anterior talofibular ligament Signup and view all the answers

Which sign indicates an inability to bear weight that suggests a possible fracture according to the Ottawa ankle rules?

Inability to bear weight for 4 steps Signup and view all the answers

In the context of Salter Harris classification, which type indicates a crush injury to the growth plate?

Type 5 Signup and view all the answers

Which fracture is characterized by an outstretched hand landing on the wrist area?

Colles fracture Signup and view all the answers

What finding suggests a Supracondylar fracture in children?

Presence of a posterior fat pad sign Signup and view all the answers

Which type of fracture is most commonly associated with elbow injury in adults?

Radial head fracture Signup and view all the answers

Which of the following describes a Greenstick fracture?

Partial fracture of the cortex with intact opposite side Signup and view all the answers

Which is NOT a treatment method for managing an ankle sprain?

Surgical fixation Signup and view all the answers

What is a characteristic feature of a Hills Sachs Deformity?

Commonly seen after anterior shoulder dislocations Signup and view all the answers

What condition can often accompany ankle sprains?

Tibiofibular interosseous membrane strain Signup and view all the answers

Study Notes

Movement Disorders

Hyperkinetic Disorders: Include tremor, chorea, dystonia, myoclonus, tics, and stereotypies.
Hypokinetic Disorders: Primarily Parkinsonism, may also include hyperkinetic movements.

Tremor Characteristics

Resting Tremor: Seen in Parkinson's Disease.
Postural Tremor: Most commonly associated with essential tremor.
Action Tremor: Jerk-like movements due to cerebellar lesions.

Chorea

Abrupt, irregular body movements associated with conditions like Huntington's and Wilson's diseases.
Can be drug-induced (e.g., neuroleptics, dopaminergics) or due to toxins (e.g., alcohol, carbon monoxide).
Other causes include systemic lupus erythematosus (SLE), post-streptococcal infections, pregnancy, and vascular damage to the caudate.

Dystonia

Characterized by sustained muscle contractions causing repetitive movements or abnormal postures.
Types include focal (e.g., blepharospasm, writer's cramp) and generalized forms.
Causes: primary idiopathic (e.g., torsion dystonia) or secondary (e.g., Wilson's, Huntington's).

Myoclonus

Sudden lightning-like muscle contractions; examples include hiccups and epileptic jerks.
Managed with medications such as clonazepam and valproate.

Tics

Stereotyped movements or vocalizations that can be voluntarily suppressed but cause anxiety if held back.
Tourette's Syndrome is a key example, managed with dopamine agonists and SSRIs.

Parkinson's Disease

Progressive neurodegenerative condition affecting dopaminergic neurons.
Symptoms include tremor (resting), stiffness, bradykinesia, and balance difficulties.
Pathophysiology involves dysfunction in the substantia nigra and striatum due to Lewy body accumulation.
Risk factors include environmental exposures and concussion history, more common in males.

Huntington's Disease

Autosomal dominant disorder characterized by chorea, personality changes, and dementia.
The gene responsible is the Huntingtin gene on chromosome 4, linked to trinucleotide repeat expansions.
Symptoms include progressive movement disorders and high suicide risk, with death typically occurring 10-20 years post-onset.

Wilson's Disease

Autosomal recessive disorder leading to copper accumulation in various organs.
Symptoms manifest as hyperkinetic movements, tremors, and cognitive changes.
Diagnosis includes measuring serum copper and ceruloplasmin levels and a 24-hour urine copper test.

Spinal Cord Pathology

Common causes include trauma, tumors, hemorrhages, and nutritional deficiencies (e.g., B12).
Symptoms of spinal cord damage include upper motor neuron signs, complete sensory loss below the lesion, and bowel/bladder dysfunction.
Brown-Sequard Syndrome: Caused by hemisection of the cord, presenting with ipsilateral weakness and loss of joint position sense, and contralateral pain and temperature loss.

Central Cord Syndrome

Often associated with intramedullary spinal tumors, syringomyelia, and Chiari malformations.
Symptoms may include loss of motor function in upper extremities and a “cape-like” loss of sensation in arms.

Lambert-Eaton Myasthenic Syndrome (LEMS)

Rare autoimmune condition linked to malignancies, primarily small cell lung carcinoma.
Presents with bulbar symptoms like ptosis and diplopia; sensory changes are absent.

Plexopathy

Injuries to brachial plexus roots (C5-T2) lead to conditions like Erb's or Klumpke's palsies.
Symptoms include shoulder weakness, anesthesia, and weakness in specific dermatomal distributions.

Mononeuropathy

Mononeuritis multiplex: Painful, asymmetrical neuropathy affecting multiple nerve areas.
Associated with conditions such as diabetes, infections, and vasculitis.

Carpal Tunnel Syndrome

Caused by median nerve compression, resulting from overuse or anatomical predispositions.
Symptoms include numbness in the radial three and a half digits and pain in the volar aspect of the hand.

Fibromyalgia

Characterized by chronic widespread pain and associated with sleep disorders; primarily affects young women.
Diagnosis is exclusionary, with treatments focusing on symptom management rather than anti-inflammatory medications.

Osteoporosis in Women

Osteopenia is a precursor; risk factors include decreased estrogen, certain diseases, and lifestyle factors.
Screening recommended for women over 65 or with risk factors; DEXA scans measure bone density.

Vitamin D Deficiency

Insufficient dietary intake and sun exposure lead to decreased active Vitamin D synthesis, impacting bone health.

Paget's Disease

Characterized by chaotic bone remodeling, leading to weaker new bone formation and asymmetrical enlargement of bones.
Commonly affects pelvis, skull, and femur; treatment involves bisphosphonates.

Ankle Sprain

Most frequent ankle injury, typically caused by inversion/supination stress, affecting the anterior talofibular ligament.
Treatment focuses on PRICE (Protection, Rest, Ice, Elevation) and may require X-ray evaluation using Ottawa ankle rules.

Classic Fractures

Colles, reverse Colles, snuff box, and stress fractures are significant types with unique presentation and management strategies.
Pediatric fractures often involve growth plates; Salter Harris classification is used to determine prognosis.

Immediate Orthopedic Consultation

Required for specific pediatric fractures like supracondylar, which risk neurovascular injury.
Clinical management considerations for rib fractures and tension pneumothorax crucial for patient safety.

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Description

This quiz covers musculoskeletal movement disorders, focusing on both hyperkinetic and hypokinetic conditions. Learn about tremors, chorea, dystonia, myoclonus, and the impacts of disorders like Parkinsonism and Huntington's disease. Test your knowledge on the symptoms and treatment options for these conditions.