Case 7 - tests

Question 1

what do PET and DaTSCAN focus on

Answer 1

dopamine, using radio tracers to measure dopamine function in the basal ganglia. only detect change once disease has been well established

Question 2

what is a flurodopa pet scan

Answer 2

FDOPA is a fluorinated form of L-dopa that is synthesised for use as a radio tracer in PET scans

Question 3

what is a PET scan useful for

Answer 3

distinguishing PD from other rtpes of neurodegeneration

Question 4

how does a PET scan work

Answer 4

detects pairs of gamma rays that are emitted indirectly by a positron emitting radionuclide which is introduced in dopamine

Question 5

what is the radionuclide introduced in dopamine

Answer 5

18F flurodopa

Question 6

what ia dAtSCAN

Answer 6

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

Question 7

what does the DaTSCAN predict

Answer 7

how advanced the disease will be in 5 years

Question 8

how is parkinsons clinically classified

Answer 8

according to the age of onset

Question 9

what is PD referred to if the symptoms begin after 50

Answer 9

usually referred to as late onset disease

Question 10

when is PD classified as early onset

Answer 10

if signs and symptoms begin before the age of 50

Question 11

what is juvenile onset PD

Answer 11

cases that begin before the age of 20

Question 12

what is the most common type of PD

Answer 12

the late onset form is the most common type

Question 13

what is the UPDRS

Answer 13

Considered the gold standard for determining the severity and progression of PD

Question 14

what is the MDS-UPDRS four main areas

Answer 14

non motor experiences of daily living
motor experiences of daily living
motor examination
motor complications

Question 15

what is the most widely used part of the UPDRS model

Answer 15

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

Question 16

what is the ICF and how does it differ from the UPDRS

Answer 16

Was developed to provide an underlying framework for understanding the consequences of a disease from body, individual and societal perspectives.

Question 17

what are the three domains of human function that the effects of the disease are considered

Answer 17

body structure and function
activity and participation
environmental factors

Question 18

what is used to denote a decrement at each level q

Answer 18

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

Question 19

what does the ICF do

Answer 19

mainstreams the experience of disability and recognises it as a universal human experience

Question 20

what is the other factor the ICF takes into account

Answer 20

the social aspects of disability and does not seee disability as a medical or biologic dysfunction

Question 21

what is the Hoehn and Yahr Staging scale

Answer 21

describes how symptoms progress in PD. it has bee widely used because it is simple and identifies parterres of progressive motor impairment

Question 22

what does the H and Y scale not provide

Answer 22

information about non motor aspects of PD

Question 23

what is stage one of this model

Answer 23

unilateral movement only

Question 24

what is stage 1.5 of this model

Answer 24

unilateral and axial involvement

Question 25

what is stage 2 of this model

Answer 25

bilateral involvement without impairment of balance

Question 26

what is stage 2,5 of this scale

Answer 26

mild bilateral disease with recovery on pull test

Question 27

what is stage 3 of this scale

Answer 27

mild to moderate bilateral disease; some postural instability; physically independent

Question 28

what is stage 4 of this scale

Answer 28

severe disability; still able to walk and stand unassisted

Question 29

what is stage 5 of this scale

Answer 29

confinement to bed or wheelchair unless aided

Question 30

what is the Schwab and England ADL scale

Answer 30

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)

Question 31

what is the triad of PD

Answer 31

tremor
rigidity
bradykinesia (slowness of movement and speed as movements are continued)

Question 32

what is the SPECT scan

Answer 32

type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3D pictures

Question 33

how does the SPECT scan work

Answer 33

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.

Question 34

what is the typical radioisotopes used in SPECT

Answer 34

iodine-123, thallium-201 and fluorine-18.