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Psych > Chapter 8 Pt 5 > Flashcards

Chapter 8 Pt 5 Flashcards

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1
Q

what is Parkinson’s Disease

A

an idiopathic, progressive neurodegenerative disease characterized by depletion of DOPAMINE in the BASAL GANGLIA
put o 75% of patients with PD meet criteria for major NCD, typically late in the course of the disease

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2
Q

what are the clinical manifestations of PD

A

rigidity, resting tremor, bradykinesia, and postural instability
cognitive manifestations consist of executive dysfunction and visuospatial impairments
depression, anxiety, personality changes, and apathy are common
psychotic symptoms may result from disease itself or medications

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3
Q

how is PD diagnosed

A

requires presence of BRADYKINESIA and either TREMOR or RIGIDITY

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4
Q

what is required for PD diagnosis

A

BRADYKINESIA

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5
Q

what is good supporting information that the diagnosis is PD

A

asymmetry of motor symptoms and favorable response to dopaminergic therapy support the diagnosis

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6
Q

mild or major NCD is attributable to PD if

A

COGNTIVE DECLINE APPEARS AFTER THE ONSET OF MOTOR SYMPTOMS and no other underlying etiology is identified

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7
Q

how is PD treated

A

CARBIDOPA-LEVODOPA and/or DOPAMIE AGONISTS
cholinesterase inhibitors are used to treat cognitive symptoms and may also ameliorate some of the neuropsychiatric symptoms (hallucinations)
psychotic symptoms may respond to decrease in dopamine agonsits

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8
Q

what are the preferred mediations for treatment of psychotic symptoms in PD not responsive to dose reduction

A

QUEITAPINE and CLOZAPINE

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9
Q

symptoms of parkinson’s can be exacerbated by what medications

A

antipsychotics

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10
Q

what is Prion Disease

A

form of subacute spongiform encephalopathy caused by proteinaceous infectious particles (prions)
most cases occur sporadically
up to 15% are familial (autosomal DOMINANT)

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11
Q

what is the most common prion disease

A

CREUTZFELDT JAKOB disease

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12
Q

what are clinical manifestations of prion disease

A

RAPIDLY PROGRESSIVE cognitive decline
difficulties with CONCENTRATION, MEMORY, and JUDGEMENT occur early

more than 90% of patients have MYOCLONUS (often provoked by startle)
depression, apathy, and hypersonic are also common
basal ganglia and cerebellar dysfunction: ATAXIA, NYSTAGMUS, HYPOKINESIA

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13
Q

rapidly progressive cognitive decline and MYOCLONUS suggests

A

CJD

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14
Q

how is prion disease diagnosed

A

biopsy of brain tissue or autopsy

probably CJD diagnosis: 
RAPID PROGRESSION of cognitive decline
at least 2:
-MYOCOLONUS
-visual or cerebellar signs
-pyramidal or extrapyramidal sings
-akinetic mutism
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15
Q

what are supportive findings of prion disease

A

periodic SHARP WAVE COMPLEXES on EEG
CSP positive for 14-3-3 proteins
lesions in PUTAMEN or CAUDATE nucleus on MRI

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16
Q

how is prion disease treated

A

no effective treatment exists

most die within 1 year of diagnosis

17
Q

what are the 3 Ws of NPH

A 
Wobbly = gait disturbance
Wet = urinary incontinence
Wacky = cognitive impairment
18
Q

what is normal pressure hydrocephalus

A

REVERSIBLE cause of cognitive dysfunction
enlarged ventricles with located elevation of cerebrospinal fluid pressure but normal opening pressures on LP
idiopathic or secondary to obstruction of CSF absorption sites due to infections (meningitis) or hemorrhage (subarachnoid or intraventricular)

19
Q

what are the clinical manifestations of NOH

A

GAIT DISTRBACNE

  • magnetic gait (appear to be stuck to floor)
  • FRIST MANEFESTATION
  • slow with short steps, broad-based
  • MOST RESPONSIVE TO TREATMENT

URINARY INCONTENCE

  • may begin as urgency
  • gait disturbance may interfere with reaching bathroom

Cognitive Impairment

  • insidious onset
  • executive dysfunction
  • physchotor retardation
  • decreased attention
  • apathy
20
Q

what is seen on neuroimaging in NPH

A

ventricles out of proportion to cortical atrophy

21
Q

how is NPH treated

A

placement of a shunt (usually ventriculoperitoneal) may improve symptoms

cognitive impairment least likely to improve

Psych (35 decks)

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