Key Elderly Conditions

Question 1

Diagnosis of Parkinson’s

Answer 1

Clinical & CT SPECT

Question 2

Triad of symptoms Parkinsons Disease

Answer 2

Bradykinesia
Resting tremor at 3-5hz
Rigidity - cog wheel & lead pipe

Question 3

Examination features Parkinson’s disease

Answer 3

Short shuffling gait with reduced arm swing 
Freeze on rotation 
Wide turning circles
Stooped posture 
Mask like facies 

Bradykinesia

• Finger tapping
• Draw circles

Question 4

Symptoms parkinsons disease Early

Answer 4

Early

• Constipation
• Anosmia
• REM sleep disturbance (very specific)
• Foot dragging

Question 5

Symptoms later parkinsons disease

Answer 5

Mask like face
Flexed posutre
Micrographia 
Postural instability 
Cognitive impairment 
Autonomic dysfunction (bladder problems, postural hypotension)
Dysphagia

Question 6

Management PD

Answer 6

Levodopa with Peripheral dopadecarboxylase
Dopamine agonists
MAO-I (hypertensive crisis)

Question 7

Other parkinsons syndromes

Answer 7

MSA (PD+autonomic)
Progressive supranuclear palsy (PD+eye problems)
Lewybody dementia (cognitive problems in first year)
Normal pressure hydrocephalus (wet, wacky, wobbly)

Question 8

Why does PD give falls risk?

Answer 8

• Autonomic symptoms (postural hypotension, functional incontinence)
• Bradykinesia (poor correction)
• Dementia