Mock Test for Parkinson's diseases

Question 1

a slowly progressive degenerative neurological disorder, characterized by tremors, muscular rigidity, bradykinesia, and postural and gait abnormalities

Answer 1

Parkinson’s Disease
Idiopathic Parkinsonism
Primary parkinsonism
Paralysis Agitans

Question 2

the cause is unknown while the treatment may be palliative the disease incurable.

most patient suffer from this type of parkinsonism

hypothesis of neuronal loss might be cause by toxins and exposure to free radicals

aka: Classic Parkinson’s Disease of Paralysis Agitans

Answer 2

Primary Parkinson’s Disease (Idiopathic)

Question 3

may cause by the drugs, including Dopamine antagonist such as Phenothiazines, Butyrophenones and Reserpine

Caused by poisoning from chemicals or toxins such as CO heavy metals and MPTP

May be cause by the atherosclerosis, degenerative diseases of the CNS and Metabolic disorder

from a known cause

Answer 3

Secondary Parkinson’s Disease

Question 4

many other motor symptoms may occur.

Non- motor symptoms:
cognitive changes
depression, anxiety, apathy, irritability
hallucination and delusions
sleeping problems
swallowing, chewins, speaking difficulty
unrinary or constipation problems

Answer 4

Parkinson’s Disease (PD)

Question 5

IPD means

Answer 5

idiopathic Parkinson’s disease

Question 6

other symptoms occurs, not generally present in PD, and vary based on the specific form of the Parkinson’s plus syndrome.

6 common forms are:
Multiple system atrophy (MSA)
Progressive supranuclear palsy (PSP)
Cortibasal syndrome (CBS)
Dementias w/ Lewy bodies (DLB)
drug- induced parkinsonism
vascular parkinsonism (VP)

also referred to as “atypical parkinonism or parkinson’s plus syndrome”

Answer 6

Parkinsonism

Question 7

deplete biogenic monoamines from their storage sites

theses drugs may therefore produce a parkinsonian syndrome usually 3 within 3 months after introduction

Drug- induced parkinsonism

Answer 7

Reserpine / Tetrabenzine

Question 8

______ and the ____ block dopamine receptors

Answer 8

Haloperidol and phenothiazine

Question 9

sign and symptoms of PD “TRAP: means

Answer 9

Tremor
Rigidity
Akinesia
Postural difficulties

Question 10

Inc. of Ach, most evident at rest and w/ low frequency movement
aka Pill- Rolling _____

Answer 10

Tremor

Question 11

detected when arm responds w/ rachet-like movement when the limb moved passively

Answer 11

Limb Rigidity

Question 12

difficulty in initiating movements: Slowness in performing common voluntary movements

Answer 12

Akinesia/ Bradykinesia

Question 13

patient walk w/ a stopped, flexed posture

Answer 13

Gait and Postural difficulties

Question 14

depression 50%, dementia 25% and psychosis

Answer 14

changes in mental status

Question 15

stages of pd: no clinical signs evident

Answer 15

stages 0

Question 16

stages of pd: unilateral movements

Answer 16

stage 1

Question 17

stages of pd: bilateral involvement but no postural abnormalities

Answer 17

stage 2

Question 18

stages of pd: Mild to moderate bilateral disease

Answer 18

stage 3

Question 19

stages of pd: bilateral involvement w/ postural instability

Answer 19

stage 4

Question 20

stages of pd: severe diseases

Answer 20

stage 5

Question 21

precursor of dopamine agonists

Answer 21

Levodopa and carbidopa

Question 22

Direct acting Dopamine agonist :Ergot derivative

Answer 22

Bromocriptine, pergolide

Question 23

Direct acting Dopamine agonist: Non-Ergot derivative

Answer 23

Pramipexole / ropinirole

Question 24

COMT inhibitors

Answer 24

Tolcapone and Entacapone

Question 25

COMT means

Answer 25

catechol- o- methyltransferase

Question 26

indirect- acting Dopamine agonists: Dopamine releaser

Answer 26

Amantadine

Question 27

indirect- acting Dopamine agonists: monoamine oxidase inhibitors

Answer 27

Selegiline

Question 28

Anticholinergics/ antimuscarinics

Answer 28

Benztropine, biperiden, trihexyphenidyl, orphenadine and procyclidine

Question 29

Moa: L-dopa is converted to Dopamine by dopa decarboxylase thereby inc the CNS levels of DA in the brain carbidopa inh metabolism of L-dopa thereby inc level of DA in the CNS

Answer 29

Carbidopa Levodopa (sinemet)

Question 30

Carbidopa Levodopa (sinemet) ADR:

Answer 30

Gi: Anorexia , N/V, adominal pain CV: postural hypotension and tachycardia musculoskeletal: dyskinesia/ Choreiform movement CNS: depression , fluctuation in response Hematologicals: Anemia others: Mydriasis, glaucoma, hot flushes, gout, agranulocytosis, wearing off reaction

Question 31

drug interaction: may inc efficacy of levodopa

Answer 31

Amantadine, benztropine, procyclidine, trihexyphenidyl

Question 32

drug interaction: inc peripheral breakdown of L-dopa

Answer 32

Pyridoxine

Question 33

drug interaction: Hypertension crisis

Answer 33

L-dopa + Phenelzine

Question 34

drug interaction: block dopamine receptor /parkinsonian receptor

Answer 34

antipsychotic drugs

Question 35

used in hyperprolactinemia moa: partial D2 agonist and adjunct to L-dopa

Answer 35

Bromocriptine (Parlodel)

Question 36

Bromocriptine (Parlodel) ADR:

Answer 36

1st dose phenomenon dizziness drowsiness fainting cardiac arrhythmias postural hypotension tachycardia

Question 37

moa: stimulate d1 & d2 receptors more effective than bromocriptine (1000x) inh secretion of prolactine, inc serum conc of GH, dec. the serum conc of LH used as adjunct treatment to L-dopa and C-dopa

Answer 37

Pergolide(Permax)

Question 38

Pergolide(Permax) ADR:

Answer 38

Hypersensitivity

Question 39

moa: d3 receptor agonist used as monotherapy for mild parkinsonism helpful in patient w/ adverse disease permitting dec. of dose of L-dopa Has ability to scanvenge H2O2 and inc neuropathic activity in mesencephalic dopamine cell

Answer 39

Pramipexole (mirapex)

Question 40

Pramipexole (mirapex) ADR:

Answer 40

Symptomatic hypotension & constipation

Question 41

Moa: d2 agonist monotherapy in patient w/ mild disease and as a means od smoothing the response to L- dopa

Answer 41

Ropinirole (requip)

Question 42

Ropinirole (requip) ADR:

Answer 42

Syncope bradycardia dizziness somnolence symptomatic hypotension hallucinations Headache Fatigue

Question 43

Moa: Da agonist temporary relief of "off-periods" of akinesia

Answer 43

Apomorphine (apokyn)

Question 44

Apomorphine (apokyn) ADR:

Answer 44

severe nausea dyskinesia hypotension drowsiness sweating

Question 45

moa: selective , reversible inh used as adjunct to l-dopa /c-dopa therapy inh comt peripherally and centrally prolong action of l-dopa improve response and prolonging "on time" result in doubling of the elimination t 1/2 of l-dopa and inc oral BA of L-dopa (40-50%)

Answer 45

Tolcapone (tasmar)

Question 46

Tolcapone (tasmar) ADR:

Answer 46

Liver failure, hyperpyrexia and confusion

Question 47

moa: slective and reversible inh of comt only in peripherally improves duration of "on time" and dec" off time"

Answer 47

Entacapone (Comtan)

Question 48

Entacapone (Comtan) ADR

Answer 48

rapid with drawal; causes hyperpyrexia and confusion

Question 49

moa: mao B inh (DA) mao a inh (high doses) (ne, 5-ht, DA) more potent than selegiline in preventing MPTP- induced parkinsonism neuroprotective agent

Answer 49

Rasagiline (azlect)

Question 50

Rasagiline (azlect) ADR:

Answer 50

Flu syndrome, arthralgia, depression & dyspepsia

Question 51

moa: selective inh of Mao B b retards breakdown of DA enhance & prolong fix of L-dopa MAO-a INH (high dose) Used as adjunctive therapy for patient w/ declining response to L-dopa/C-dopa reduce" end of dose" or " on- off" fluctuation in response

Answer 51

Selegiline (selegos)

Question 52

Selegiline (selegos) ADR:

Answer 52

HTN crisis & inc l-dopa side effect

Question 53

inc Da level at the postsynaptic receptor sites by dec reuptake & enhance Da synthesis & releases anti viral agent anticholinergic effect decreases TRAP Symptoms given in combi w/ l-dopa

Answer 53

amantidine

Question 54

amantidine ADR:

Answer 54

livedo reticularis (netlike rashes)

Question 55

contraindication of amantidine

Answer 55

seizures and heart failure

Question 56

blocks the excitatory neurotransmitter cholinergic influence in the basal ganglia more effective for tremor/rigidity used for mild symptoms tremors less effective for bradykinesia & less effective for postural imbalance

Answer 56

anticholinergics

Question 57

may be alleviated by b- blocker including ___ but caution w/ CHF, asthma, diabetes & hypoglycemia

Answer 57

Propranolol

Question 58

__ has been used w/patientt w/ concomitant pulmonary diseases

Answer 58

Metoprolol

Question 59

types of tremor: normal phenomenon, enhanced amplitude by anxiety, fatigue, thyrotoxicosis and iv epi

Answer 59

Physiologic postural tremor

Question 60

types of tremor: A postural tremor. sometimes familial

Answer 60

essential tremor

Question 61

types of tremor: present during movement

Answer 61

intention tremor

Question 62

types of tremor: due to parkinsonism

Answer 62

Rest tremor

Question 63

an inherited disorder characterized by progressive chorea and dementia that begins at adulthood related to imbalance of DA, ACH, GABA & perhaps other neurotransmitter in the basal ganglia

Answer 63

Huntington's Disease

Question 64

a continuous stream of slow, sinuous writhing movements, typically of the hands and feet it is said to caused damage by corpus striatum of brain movements typical to ___ isa called athetoid movements

Answer 64

Athetosis

Question 64

unpleasant creeping discomfort in the limbs that occurs particularly when the patient is at rest more common in pregnant women, uremic & diabetic patients opioid analgesics & BZD are also used for treatment

Answer 64

Restless legs syndrome

Question 65

Dopaminergic therapy is the preferred treatment & ___, a long-acting drug for restless legs syndrome

Answer 65

ropinirole

Question 66

inherited disorder of copper metabolism results in deposition of copper salts in the liver and other tissues

Answer 66

Wilson's Diseases

Question 67

Violent movements of the limbs , as in chorea, sometimes affecting only one side of the body

Answer 67

Ballismus

Question 68

unknown cause that frequently responds to haloperidol and other dopamine D2 receptor blockers pimozide.

Answer 68

Tourette's syndrome

Question 69

treatment for Hutington's disease

Answer 69

haloperidol, tetrabenazine

Question 70

treatment for wilson's disease

Answer 70

chelating agent , D penicillamine, trientine