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Understanding Hyperkinetic and Hypokinetic Disorders: Key Features and Pharmacological Approaches

This clinical quiz focuses on neurodegenerative disorders characterized by various abnormal movements, including akathisia, athetosis, dystonia, and Parkinsonism. It covers essential clinical signs, such as resting tremor, rigidity, bradykinesia, and postural instability. Additionally, it delves into pharmacological treatments like MAO inhibitors and COMT inhibitors used to enhance dopamine activity in patients. The quiz aims to reinforce understanding of movement disorders' clinical manifestations and management strategies, crucial for clinicians in neurology and related fields.

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Understanding Hyperkinetic and Hypokinetic Disorders: Key Features and Pharmacological Approaches

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  1. NS wk 1-Clinical Quiz - Neurodegenerative Disorders

  2. Motor restlessness; constant semi purposeful movements of arms and leg? AKITHESIA • Sudden loss of muscle tone during sustained contraction of an outstretched limb? ASTERIXIS • Writhing, slow sinuous movements, especially of the hands and wrists ATHETOSIS

  3. Sustained contraction of groups of agonist and antagonist muscles, usually in flexion or extremes of extension – resulting in bizarre postures • Dystonia • An exaggerated form of chorea involving one side of the body- wild flinging movements • Hemiballismus • A brief muscle contraction which causes a sudden purposeless jerking of a limb • Myoclonic jerk

  4. A repeated contraction of a small muscle group, often involving the orbicularisoculi muscles • Myokymia • A repetitive irresistble movement which is purposeful or semi-purposeful Tic • Jerky small rapid movements, often disguised by the patient with a purposeful final movement CHOREA • Purposeless and continuous movements, often of the face and mouth DYSKINESIA

  5. Tremor of rate between 3 and 5Hz is a SLOW TREMOR • Tremor of rate faster than 10Hz is a FAST TREMOR • Tremor mainly present during relaxation of muscles is a RESTING TREMOR • Tremor occuring with deliberate movement is a/an INTENTION TREMOR • A fine tremor associated with holding a posture or performing a movement slowly is a PHYSIOLOGICAL TREMOR (normal) • Shivering is a type of tremor T/F?? TRUE

  6. Hyperkinetic Movements on a Scale from most jerky/violent to more sustained Chorea Myoclonus Dystonia Athetosis Ballismus 1. 2. 3. 4. 5.

  7. 8 signs of a patient presenting with Parkinsonism • Tremor • Rigidity • Bradykinesia • Postural instability • Mask-like facies • Gait: festinating • Hypophonia • Micrographia

  8. Pharm. - Selegiline is a MAO inhibitor (selective and irreversible) Its therapeutic effect is to inhibit breakdown of DA therefore enhancing the activity of DA - Entacapone is a COMT inhibitor Its therapeutic effect is to inhibit breakdown of DA and L-dopa therefore enhancing the activity of DA and L-dopa

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