elm 3.1

Question 1

what sex is more at risk for parkinson’s?

Answer 1

male

Question 2

NSAID use can decrease risk of parkinson’s T or F

Answer 2

T

Question 3

there is clear evidence for loss of _____ neurons from specific brain region (_____) in parkinson’s

Answer 3

dopaminergic
substantia nigra pars compacta (SNpc)

Question 4

substantia nigra is ____ in patients with parkinson’s

Answer 4

lost

Question 5

another change in parkinson’s is the appearance of ____ - intracellular inclusions mostly consisting of protein _____

Answer 5

lewy bodies

alpha synuclein

Question 6

what are some genes linked to PD?

Answer 6

SNCA
PRKN
PINK1
PARK7

Question 7

what is SNCA important for?

Answer 7

synaptic function, DNA repair - major component of lewy bodies

Question 8

what is PRKN important for?

Answer 8

proteasome and mitochondrial function

Question 9

what is PINK1 important for?

Answer 9

mitochondrial function

Question 10

what is PARK7 important for?

Answer 10

protects against oxidative stress

Question 11

dopaminergic neurons of the substantia nigra are very sensitive to ___ and are killed by a build up of ____ (a loss of these neurons leads to PD symptoms)

Answer 11

MPP
free radicals

Question 12

what are the four cardinal features of PD that essentially define the disease?

Answer 12

bradykinesia
resting tremour
rigidity
postural instability

Question 13

describe bradykinesia

Answer 13

slowed movement
loss of movement amplitude
reduced facial expression
reductions in writing size
repetitive actions

Question 14

desribe resting tremour

Answer 14

often seen in hands but can develop elsewhere
pill roling tremour - early stages

Question 15

describe rigidity

Answer 15

stiffness in limbs
lead pipe - smooth resistance to mvmt
cogwheel - ticking lilke second hand on clock

Question 16

describe postural instability

Answer 16

loss of postural reflexes
develop a stooped posture as well
not primarily due to loss of dopaminergic neurons
leads to falls which are very serious

Question 17

the basal ganglia links ____ back to cerebral cortex through ____, with links to spinal output

Answer 17

cerebral cortex
thalamus

Question 18

hyperdirect pathway ____ mvmt

Answer 18

inhibits

Question 19

carbidopa and benserazide are examples of what?

Answer 19

peripheral inhibitors

Question 20

what do peripheral inhibitors do?

Answer 20

prevent peripheral side effects, can’t cross BB

Question 21

can tolcapone cross the BBB

Answer 21

yes

Question 22

what does tolcapone do

Answer 22

increases dopamine availability

Question 23

what does it mean that the effects w the drugs needed for parkinson’s could ‘wear off’

Answer 23

the dopamine buffer decreases as the disease progresses

Question 24

domperidone is a DA _____ but does / does not cross BBb

Answer 24

antagonist
does not

Question 25

domperidone can enter the _____ because the BBB is ______

Answer 25

chemoreceptor trigger zone leaky there

Question 26

bromocriptine, pergolide, and apomorphine are examples of what

Answer 26

older dopamine agonists

Question 27

older dopamine agonists are ____ selective, and can be co-administered with _____

Answer 27

less domperidone (does not cross BBB)

Question 28

pramipexole and ropinirole are ___ selective and more active at __ and __ receptors

Answer 28

more D2 D3

Question 29

benztropine and procyclidine are mAChR _____

Answer 29

antagonists

Question 30

mAChR regulate __ at multiple points

Answer 30

BG

Question 31

amantadine ____ release of dopamine, but cannot be used on its own - it can be used as ____

Answer 31

increases adult therapy

Question 32

deep brain stimulation has replaced ___

Answer 32

ablation therapy

Question 33

does DBS improve non-dopamine problems

Answer 33

no

Question 34

Which of the following drugs is NOT a first line treatment for Parkinson's Disease? a. Bromocriptine b. Co-beneldopa c. Rasagiline d. Tolcapone

Answer 34

a

Question 35

Which of the following brain regions would be the best choice for deep brain stimulation to treat Parkinson's Disease? a. Striatum b. Substantia nigra c. Subthalamic nucleus d. Thalamus

Answer 35

c

Question 36

What is the mechanism of action of benztropine? a. Dopamine agonist b. COMT inhibitor c. MAO B inhibitor d. Muscarinic receptor antagonist

Answer 36

d