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Neuroscience 2 > Clinical Features of Parkinson's Disease > Flashcards

Clinical Features of Parkinson's Disease Flashcards

State the motor and non-motor features of PD Understand and discuss the rational basis for drug treatments of PD and the main complications of treatment Appreciate and discuss the non-medication based aspects of PD management, relating both to the patient, family, carers, and society at large

1
Q

Name the four core features of Parkinson’s disease

A

Pill-rolling tremor, rigidity, bradykinesia, and loss of postural reflexes

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2
Q

Name four domains affected by Parkinson’s disease

A

Motor, neuropsychiatric, autonomic, and sleep

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3
Q

Give at least 4 motor symptoms of Parkinson’s disease

A

Tremor, rigidity, akinesia, bradykinesia, clumsiness, loss of postural reflexes, falls, dystonia, cramps

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4
Q

Give at least 4 neuropsychiatric symptoms of Parkinson’s disease

A

Hallucinations, anxiety, confusion, stupor, impulsivity, depression, cognitive decline, dementia, paranoia, visuospatial dysfunction

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5
Q

Give at least 4 autonomic and vegetative symptoms of Parkinson’s disease

A

Bladder and bowel dysfunction, hypotension, impotence dysarthria, dysphagia, drooling, rash, anosmia

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6
Q

Give at least 4 sleep symptoms of Parkinson’s disease

A

Restless leg syndrome, REM sleep disorder, nightmares, nocturia, periodic limb movement disorder, immobility, pain

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7
Q

Give 2 classes of drugs which can cause parkinsonism

A

Dopamine blockers and calcium blockers

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8
Q

Where does Parkinson’s disease pathology typically start?

A

The dorsal basal nucleus and vagus nerve, and the olfactory system

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9
Q

Name 2 other alpha-synucleinopathies

A

Dementa with Lewy bodies and multiple system atrophy

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10
Q

Name the 3 disorders encompassed by multiple system atrophy

A

Olivopontocerebellar atrophy (OPCA), striatonigral degeneration, and Shy-Drager syndrome

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11
Q

Name 2 tauopathies which cause parkinsonism

A

Corticobasal degeneration and progressive supranuclear palsy

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12
Q

State the prevalence of Parkinson’s disease

A

0.2-0.4%, increasing with age

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13
Q

State the prevalence of Parkinson’s disease in those over 65

A

2-3%

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14
Q

Degeneration of which systems produces motor symptoms?

A

Substantia nigra and pedunculopontine nucleus (PPN)

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15
Q

Degeneration of which systems produces sleep symptoms?

A

Hypothalamus, pedunculopontine nucleus (PPN), thalamus, raphe nucleus, RAF

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16
Q

Degeneration of which systems produces autonomic symptoms?

A

Hypothalamus, medullary nuclei, spinal cord, peripheral ganglia

17
Q

Degeneration of which systems produces cognitive symptoms?

A

Substantia vigra, ventral tegmental area (VTA), locus coeruleus, raphe nucleus, basal forebrain, limbic system, hippocampus, cerebral cortex, thalamus

18
Q

Degeneration of which systems produces sensory symptoms?

A

Olfactory pathway, visual pathway, association cortex

19
Q

Name the 2 main neurotransmitter’s involved in Parkinson’s disease

A

Dopamine and acetylcholine

20
Q

Name 2 indirect dopamine agonists used in Parkinson’s disease

A

L-DOPA (dopamine precursor) and amantadine (increases dopamine release)

21
Q

Name at least 2 direct dopamine agonists used in Parkinson’s disease

A

Apomorphine, pramipexole, ropinirole, rotigotine

22
Q

Name at least 2 COMT inhibitors used in Parkinson’s disease

A

Entacapone, tolcapone, opicapone

23
Q

Name 2 MAO inhibitors used in Parkinson’s disease

A

Selegiline, rasagiline

24
Q

Why must levodopa be co-administered with a decarboxylase inhibitor?

A

To prevent it being converted to dopamine outside of the CNS

25
Q

How much levodopa reaches the brain?

A

Less than 5%

26
Q

Why can dextrodopa not be used?

A

It causes haematological toxicity

27
Q

Name 2 sustained release levodopa formulations and the symptom group they are most effective for

A

POS: Increased active time, tends to improve sleep
NEG: Slow active onset, tends to improve dyskinesia

28
Q

Why should levodopa be avoided in younger patients

A

To delay the development of tolerance

29
Q

State some side effects of dopamine agonists

A

Nausea, vomiting, hypotension, somnolence, sleep attacks

30
Q

What is the most common autonomic symptom of PD?

A

Constipation

31
Q

Which antipsychotics can be used in PD?

A

Clonazepam, quetiapine, aripiprazole, or clozapine

32
Q

What is the most common neuropsychiatric symptom of PD?

A

Confusion and agitation

33
Q

What percentage of PD patients experience memory loss?

A

50%

34
Q

Give 2 palliative treatments for treatment-resistant PD

A

Deep brain stimulation or high-energy ultrasound

Neuroscience 2 (30 decks)

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