MIDTERMS: Parkinson's Disease

Question 1

What are the cardinal features of Parkinson’s Disease (PD)?

Answer 1

Rigidity, bradykinesia, tremors, and postural instability.

Question 2

Who first described Parkinson’s Disease and in what year?

Answer 2

James Parkinson in 1817, referring to it as “the shaking palsy.”

Question 3

What is the most common form of Parkinson’s Disease?

Answer 3

Idiopathic Parkinson’s Disease, affecting approximately 78% of patients.

Question 3

How does the incidence of Parkinson’s Disease change with age?

Answer 3

Incidence increases dramatically with age, affecting more than 2% of the population older than 65.

Question 3

What is the average age of onset for Parkinson’s Disease?

Answer 3

50 to 60 years.

Question 4

Are men or women more frequently affected by Parkinson’s Disease?

Answer 4

Men are affected 1.2 to 1.5 times more frequently than women.

Question 4

What are some identifiable causes of secondary parkinsonism?

Answer 4

Viruses, toxins, drugs, and tumors.

Question 5

Name a group of drugs that can induce parkinsonian symptoms.Name a group of drugs that can induce parkinsonian symptoms.

Answer 5

Neuroleptic drugs, antidepressants, and antihypertensives.

Question 5

Name two conditions included in parkinsonism-plus syndromes.

Answer 5

Progressive supranuclear palsy and corticobasal ganglionic degeneration.

Question 5

What defines parkinsonism-plus syndromes?

Answer 5

A group of neurodegenerative diseases that produce parkinsonian symptoms along with additional neurological signs.

Question 6

What is toxic parkinsonism, and who is at risk?

Answer 6

Toxic parkinsonism occurs in individuals exposed to environmental toxins, particularly manganese, which is a hazard for miners.

Question 6

What is X-linked dystonia parkinsonism, also known as “Lubag Syndrome”?

Answer 6

A movement disorder first reported in 1975, affecting Filipino adult males, particularly those from the island of Panay.

Question 6

What differentiates Progressive Supranuclear Palsy (PSP) from Parkinson’s Disease?

Answer 6

PSP features early onset of balance and eye movement abnormalities, faster progression, and minimal tremor

Question 6

What are the key characteristics of Multiple System Atrophy (MSA)?

Answer 6

MSA is characterized by early autonomic dysfunction, cerebellar signs, and a lack of tremor.

Question 7

In Corticobasal Degeneration (CBD), what symptoms may be present?

Answer 7

CBD presents with asymmetric rigidity, apraxia, dystonia, and cognitive decline.

Question 8

What are the prominent features of Lewy Body Dementia (LBD)?

Answer 8

LBD is characterized by cognitive decline with parkinsonism, visual hallucinations, and fluctuations in consciousness.

Question 9

How does Essential Tremor (ET) differ from Parkinson’s Disease?

Answer 9

ET involves postural and action tremors without bradykinesia or rigidity.

Question 9

What is the primary pathophysiological change in Parkinson’s Disease?

Answer 9

Progressive degeneration of dopamine levels in the basal ganglia, particularly in the pars compacta of the substantia nigra.

Question 10

How does dopamine influence movement in the context of Parkinson’s Disease?

Answer 10

Dopamine influences the encoding of movement that activates upper motor neurons to coordinate and smooth movements.

Question 11

What are the hallmark symptoms of Parkinson’s Disease?

Answer 11

Rigidity, bradykinesia, tremors, and postural instability (typically in later stages).

Question 12

Describe the primary motor symptoms associated with Parkinson’s Disease.

Answer 12

Primary motor symptoms include rigidity (cogwheel and lead pipe), bradykinesia, tremor (resting tremor), and postural instability.

Question 12

What does Stage I of the Hoehn & Yahr classification indicate?

Answer 12

Stage I indicates minimal or absent symptoms, with unilateral involvement if present.

Question 12

What are some secondary motor symptoms seen in Parkinson’s Disease?

Answer 12

Secondary motor symptoms include muscle performance issues, fatigue, and gait disturbances (freezing and festinating gait).

Question 13

What is bradykinesia, and how does it manifest in Parkinson’s Disease?

Answer 13

Bradykinesia is slowness of movement characterized by reduced speed, range, and amplitude of movements, often leading to hypomimia (masked facial expression).

Question 13

List some non-motor symptoms of Parkinson’s Disease.

Answer 13

Non-motor symptoms can include sensory issues, dysphagia, speech difficulties, cognitive decline, depression, anxiety, autonomic dysfunction, and sleep disorders.

Question 13

Define rigidity in the context of Parkinson’s Disease.

Answer 13

Rigidity is increased resistance to passive motion regardless of movement velocity, often described as “heaviness” and “stiffness.”

Question 13

What are the two types of rigidity observed in Parkinson’s Disease?

Answer 13

Cogwheel rigidity (jerky resistance to movement) and lead pipe rigidity (sustained, prolonged rigidity).

Question 13

How is a tremor described in patients with Parkinson’s Disease?

Answer 13

Tremor is typically a resting tremor, initially occurring in one hand or foot and often described as a “pill-rolling” motion.

Question 14

What contributes to postural instability in Parkinson’s Disease?

Answer 14

Postural instability results from abnormal postural responses, narrowing base of support, and factors such as rigidity, decreased muscle torque production, loss of range of motion, and weakness.

Question 15

What is the average duration of Parkinson’s Disease and its impact on life expectancy?

Answer 15

The mean duration of PD is approximately 10 to 20 years, with life expectancy nearly equal to that of the general population.

Question 15

How long is the preclinical period for Parkinson’s Disease, and what does it imply?

Answer 15

The preclinical period can last from 5 to 25 years, during which there are no apparent clinical manifestations of the disease.

Question 16

What characterizes the PIGD group in Parkinson’s Disease?

Answer 16

Patients in the PIGD group present with postural instability and gait disturbances, leading to more pronounced deterioration and rapid disease progression.

Question 17

What is characteristic of Stage III in the Hoehn & Yahr classification?

Answer 17

Stage III is marked by impaired righting reflexes, unsteadiness when turning or rising from a chair, and some activity restrictions, though the patient can live independently.

Question 17

What does Stage V of the Hoehn & Yahr classification indicate regarding mobility?

Answer 17

Stage V indicates that the patient is confined to bed or a wheelchair, with severe symptoms present.

Question 18

What is the purpose of the Unified Parkinson’s Disease Rating Scale (UPDRS)?

Answer 18

The UPDRS is the gold standard for measuring the progression of Parkinson’s Disease, assessing non-motor and motor aspects of daily living.

Question 19

What are the four parts of the UPDRS?

Answer 19

Non-Motor aspects of experiences of daily living.
Motor experiences of daily living.
Motor examination.
Motor complications.

Question 20

What is the recommended approach for strength training in older adults with Parkinson’s Disease?

Answer 20

Begin at a lower intensity, perform exercises 2 days per week on nonconsecutive days, and consider using machines for safety.

Question 21

What should be included in balance training for PD patients?

Answer 21

Training should consider the patient’s limitations and include dynamic stability tasks and control of center of mass (COM) and limits of stability (LOS).

Question 22

How does aerobic exercise benefit individuals with Parkinson’s Disease?

Answer 22

Improves oxygen consumption (VO2), reduces motor disease severity, and enhances functional outcomes.

Question 23

Check CE1 flashcards

Answer 23

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