Case 7 - tests Flashcards
what do PET and DaTSCAN focus on
dopamine, using radio tracers to measure dopamine function in the basal ganglia. only detect change once disease has been well established
what is a flurodopa pet scan
FDOPA is a fluorinated form of L-dopa that is synthesised for use as a radio tracer in PET scans
what is a PET scan useful for
distinguishing PD from other rtpes of neurodegeneration
how does a PET scan work
detects pairs of gamma rays that are emitted indirectly by a positron emitting radionuclide which is introduced in dopamine
what is the radionuclide introduced in dopamine
18F flurodopa
what ia dAtSCAN
looks at the function of presynaptic dopamine transporters
has the potential to predict the course of the disease by measuring the number of dopamine transporters when compared to normal levels at an early point of PD
what does the DaTSCAN predict
how advanced the disease will be in 5 years
how is parkinsons clinically classified
according to the age of onset
what is PD referred to if the symptoms begin after 50
usually referred to as late onset disease
when is PD classified as early onset
if signs and symptoms begin before the age of 50
what is juvenile onset PD
cases that begin before the age of 20
what is the most common type of PD
the late onset form is the most common type
what is the UPDRS
Considered the gold standard for determining the severity and progression of PD
what is the MDS-UPDRS four main areas
non motor experiences of daily living
motor experiences of daily living
motor examination
motor complications
what is the most widely used part of the UPDRS model
the motor examination section is the most widely used measure to assess motor symptoms and is the only part scored by the healthcare provider rather than by patient self report
what is the ICF and how does it differ from the UPDRS
Was developed to provide an underlying framework for understanding the consequences of a disease from body, individual and societal perspectives.
what are the three domains of human function that the effects of the disease are considered
body structure and function
activity and participation
environmental factors
what is used to denote a decrement at each level q
disability. underscoring the value of this approach, the WHO endured the use of the ICF as the international standard to describe and measure health and disability
what does the ICF do
mainstreams the experience of disability and recognises it as a universal human experience
what is the other factor the ICF takes into account
the social aspects of disability and does not seee disability as a medical or biologic dysfunction
what is the Hoehn and Yahr Staging scale
describes how symptoms progress in PD. it has bee widely used because it is simple and identifies parterres of progressive motor impairment
what does the H and Y scale not provide
information about non motor aspects of PD
what is stage one of this model
unilateral movement only
what is stage 1.5 of this model
unilateral and axial involvement
what is stage 2 of this model
bilateral involvement without impairment of balance
what is stage 2,5 of this scale
mild bilateral disease with recovery on pull test
what is stage 3 of this scale
mild to moderate bilateral disease; some postural instability; physically independent
what is stage 4 of this scale
severe disability; still able to walk and stand unassisted
what is stage 5 of this scale
confinement to bed or wheelchair unless aided
what is the Schwab and England ADL scale
assess daily activites in terms of speed and independence. it uses a scale dividing in 10% increments starting at 100% (complete independence in all activities without slowness, difficulty or impairment) and moving to 0% (vegetative functions such as swallowing, bladder and bowel not functioning and bedridden)
what is the triad of PD
tremor
rigidity
bradykinesia (slowness of movement and speed as movements are continued)
what is the SPECT scan
type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3D pictures
how does the SPECT scan work
a tracer is injected tnto your blood stream. this is radio labelled which means it emits gamma rays that can be detected by the CT scanner. the computer collects information emitted by the gamma rays and displays it on the CT cross sections.
what is the typical radioisotopes used in SPECT
iodine-123, thallium-201 and fluorine-18.
