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Neurology Week 3 2018/19 > 7: Parkinson's disease > Flashcards

7: Parkinson's disease Flashcards

1
Q

Parkinson’s disease becomes symptomatic (early / late) in its course.

A

late

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2
Q

Which pathway is most responsible for motor function?

A

Corticospinal tract

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3
Q

Which parts of the brain are responsible for adjusting movement information?

A

Basal ganglia

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4
Q

What is the role of the cerebellum in movement?

A

Coordination

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5
Q

What is the difference between Parkinson’s disease and Parkinsonism?

A

Parkinson’s disease - specific disease process causing symptoms

Parkinsonism - PD-like symptoms caused by other factors e.g dopamine antagonists

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6
Q

Which gait is caused by damage to the cerebellum?

A

Ataxic gait

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7
Q

What are the five basal ganglia?

A

Caudate nucleus

Putamen

Globus pallidus

Substantia nigra

Subthalamic nucleus

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8
Q

What is the role of the basal ganglia?

A

Adjustment of movement impulses

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9
Q

Which neurotransmitters are involved in PD?

A

Dopamine

Noradrenaline

Acetylcholine

Serotonin

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10
Q

Which basal ganglion degenerates in PD?

A

Substantial nigra

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11
Q

Which type of neuron is lost from the substantia nigra in PD?

A

Dopaminergic neuron

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12
Q

What is the hallmark of PD on histology?

A

Lewy bodies

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13
Q

___ bodies are a hallmark of PD.

A

Lewy bodies

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14
Q

Where in the brain is the substantia nigra found?

A

Brainstem

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15
Q

Does PD spread from the substantia nigra?

A

Yes

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16
Q

___ neurons are lost from the substantia nigra in PD, causing (sensory / motor) symptoms.

A

Dopaminergic neurons

Motor symptoms

17
Q

What are the motor symptoms of PD?

A

Resting tremor

Bradykinesia (slower movements)

Rigidity

Postural instability

18
Q

Resting tremor in PD is (symmetrical/asymmetrical).

A

asymmetrical

best seen with hands in the lap

19
Q

What is bradykinesia?

A

Reduced speed of movement

20
Q

What is rigidity?

A

Increased muscle tone throughout a movement

Like dystonia - produces a stiff, “bent forward” posture

21
Q

Where do PD patients experience rigidity?

Is it unilateral or bilateral?

A

Back, neck, limbs

Unilateral in limbs

22
Q

How do you test postural stability in a patient?

A

Challenge standing posture

If PD, they will likely fall over

23
Q

People with PD often have a reduced sense of ___.

A

smell

24
Q

Broadly, there are two subtypes of PD: ___-dominant and non-dominant.

A

tremor dominant

temor non-dominant (emphasis on rigidity, postural instability)

25
Q

What are some possible non-motor symptoms of Parkinson’s disease?

A

Associated with DWLB - dementia, hallucinations

Anosmia

Sleep disorders

26
Q

Describe two types of rigidity seen in Parkinson’s disease.

A

Lead pipe rigidity - constant resistance to movement throughout a range of motion

Cogwheel rigidity - points of increased / decreased resistance to movement through a range of motion as muscle tension increases and decreases

27
Q

You need to rule out ___ Parkinsonism or other neurological diseases before diagnosing PD.

A

secondary

28
Q

Patients should be tested on drugs affecting which neurotransmitter before being diagnosed with PD?

A

dopamine

29
Q

Parkinson’s disease is a diagnosis of ___.

A

exclusion

30
Q

What is the biggest risk factor for PD?

A

Increasing age

31
Q

PD has a strong ___ component.

A

genetic

32
Q

The gene for which protein has been proven to be involved in the formation of Lewy bodies?

A

Alpha synuclein

33
Q

Alpha synuclein is a protein found in ___ ___ which is thought to be involved in PD.

A

Lewy bodies

34
Q

What are the investigations for PD?

A

Very few

i.e there aren’t any

35
Q

How is PD treated?

A

Dopaminergic treatment

i.e Dopamine agonists, which alleviate motor symptoms

36
Q

What are the side effects of Dopamine agonists and levodopa?

A

N&V

Oedema

Increased reward response –> gambling, hypersexuality, risk taking behaviour

Psychosis

37
Q

Dopaminergic therapy treats the ___ symptoms of PD.

A

motor

38
Q

How is the non-motor aspect of PD treated?

A

Specific therapies for each symptom

Neurology Week 3 2018/19 (10 decks)

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