Chapter 7- Parkinsons

Question 1

Name two genes identified in Parkinson’s

Answer 1

Parkin

LLRK2

Question 2

How many stages are there in the Braaks classification of Parkinson’s

Answer 2

6

Question 3

What’s dopamine

Answer 3

Is the main neurotransmitter involved in producing voluntary movements, with interplay from other brain chemical messengers

Question 4

What are the main cardinal features of Parkinson’s?

Answer 4

T- tremor
R- rigidity
A- akinesia/bradykinesia
P- postural instability

Question 5

When is tremor worsened?

Answer 5

At rest

By stress and fatigue

Question 6

Define hypomimia

Answer 6

Reduced degree of facial expression

Question 7

Define hypophonia

Answer 7

Soft speech

Question 8

Define micrographia

Answer 8

Small handwriting

Question 9

What type of dopamine agonist is favoured in treating Parkinson’s?

Answer 9

Non ergot

Question 10

Name two dopamine agonist tablets

Answer 10

Ropinirole

Pramipexole

Question 11

Name a transdermal patch dopamine agonist

Answer 11

Rotigotine

Question 12

Can dopamine agonists be used in monotherapy?

Answer 12

SHYEAH

Question 13

How many dopamine receptors are there?

Answer 13

D1-D5

Question 14

Ergot dopamine agonists cause what side effects?

Answer 14

Fibrosis

Question 15

What levodopa often used in combination with?

Answer 15

DOPA decarboxylase inhibitor

Question 16

Does levodopa have a long half life?

Answer 16

NO short (90mins)

Question 17

Name two types of MAO type B inhibitors

Answer 17

Rasagiline

Selegiline

Question 18

When do you used MAO type B inhibitors

Answer 18

First line or in combination with L-DOPA

Question 19

Name two COMT inhibitors

Answer 19

Entacapone

Tolcapone

Question 20

When are COMT inhibitors used

Answer 20

Given in conjunction with L-DOPA to enhance its activity

Question 21

When does dyskinesia worsen?

Answer 21

It occurs when the medicine is working at its peak level- tends to be in more advanced disease

Question 22

What types of drugs can induce Parkinsonism, give three examples

Answer 22

Drugs which block D2 receptors in the striatum e.g
Antipsychotics
Antiemetics
Sodium valproate

Question 23

Name four Parkinson’s plus syndromes

Answer 23

Multi system atrophy
Progressive supra nuclear palsy
Corticobasal degeneration
Dementia with Lewy bodies

Question 24

What is multi system atrophy?

Answer 24

Progressive neurological disorder- caused by degeneration of nerve cells in several areas of the brain

Question 25

What is progressive supra nuclear palsy

Answer 25

Degenerative disease involving the gradual deterioration and death of specific volumes of the brain

Question 26

What is restless leg syndrome / ekboms syndrome?

Answer 26

A neurologic movement disorder of the limbs, often associated with a sleep disorder

Question 27

Patients with RLS can also have PLMD what is it?

Answer 27

Periodic limb movement

Question 28

What might cause RLS/PLMD

Answer 28

Abnormalities in the central subcortical pathways Impaired brain iron homeostasis Impaired serotonin transporter in brainstem

Question 29

What is Parkinson's

Answer 29

A chronic, progressive, multi system, neurodegenerative process which has effects on motor and autonomic function, cognitive processing and emotion