Huntington's Disease
HD is passed on in an autosomal dominant pattern, caused by a ___ repeat
bonus: can state how many repeats
What is CAG
>40 repeats
Signs and symptoms of PD include..
What are tremor, rigidity, akinesia / bradykinesia and postural impairment (TRAP)?
In MS, the immune system attacks this part of the nerve in the CNS
What is myelin?
ALS involves loss of both of these neuron types
What are upper and lower motor neurons?
AD is the most common form of ___
What is dementia?
This dance-like involuntary movement is the hallmark of HD
What is chorea?
PD is a chronic progressive disease occurring because of what changes in the brain
What is substantia nigra cell death, less dopamine, basal ganglia dysfunction?
Name two MS impairments that can contribute to fatigue
Any two of what are: heat sensitivity, weakness, decreased aerobic capacity, impaired balance or ataxia, sensory loss, spasticity
What are the two types of onsets and which progresses faster?
What are limb and bulbar onset? Bulbar onset progresses faster
These two proteins build up in Alzheimer’s
What are beta amyloid plaques and tau tangles?
This scale is the standard rating tool for HD motor, cognitive, and functional status
What is the Unified Huntington's Disease Rating Scale (UHDRS)?
Movement System Diagnoses that may be present in an individual with PD...
What are Movement pattern coordination deficit, Hypometria, and Cognitive deficit ( later in progression)
There are 4 types of MS, what are they
What are Relapsing remitting (RRMS), secondary progressive (SPMS), Primary-progressive (PPMS), Progressive-relapsing (PRMS)
What are key impairments in the early stage?
What is muscle weakness, spasticity, muscle fasciculations, and muscle cramping ?
Name two structures that shrink in AD
What are the cortex (especially the frontal lobes) and the hippocampus?
In late stage HD (IV to V), the two PT approaches are these
What are compensatory and prevention?
Fall risk for PD patients on the 5x STS is
What is > 16 s
A woman with MS is fine in the morning but wiped out by 2 pm and her symptoms flare after hot showers. What do you teach her?
What are energy conservation and pacing, exercising in the morning, rest breaks, and cooling strategies?
In which stage of ALS does spasticity often decrease because of the loss of lower motor neurons?
What is the middle stage?
A 78 year old woman with AD is moving slowly, has a stiff, shuffling gait, and keeps leaning and falling backward. What motor deficits are going on?
What are bradykinesia, rigidity, postural instability, and gait impairment
A patient with HD has chorea and keeps hitting his arms on chair arms and bed rails. Name two ways to protect him
Padding the armrests or bed rails, a helmet, elbow or knee protectors, or a low bed or mattress on the floor
A 71 year old man with PD freezes at doorways, then shuffles with tiny steps. His meds are on time and his balance is stable. What intervention do you teach him and his wife?
What is external cueing (visual like floor tape, or auditory like a metronome) paired with taking a big step?
A 45 year old woman with MS starts an aerobic exercise program. Her HR and BP barely rise with exertion, and she feels lightheaded halfway through. What’s going on, and how do you monitor her?
What is autonomic dysfunction (blunted CV response, possible syncope), so use RPE and closely monitor her initial tolerance?
A woman with ALS has a new foot drop and is tripping at home. What do you recommend?
What is an AFO for foot drop, plus a home safety check and an assistive device to reduce fall risk?
An 80 year old woman with AD has been stable for months, with personality changes and slow, rigid movement. Over the last two days she’s suddenly agitated, can’t hold her attention, and her symptoms fluctuate through the day. What stage of AD is she in, what do you suspect is going on? Bonus: what would you do?
What is middle stage AD, with delirium superimposed (sudden onset, fluctuating attention)? Bonus: Hold off on progressing therapy and notify the nurse or physician to look for a cause like a UTI or medication change.