NEURO Flashcards
What features make up Parkinson’s triad?
- tremor
- rigidity
- bradykinesia
What are the features of a parkinson’s tremor? (4)
- 4-6 Hz
- pill-rolling movement
- worse at rest
- unilateral
Other than parkinson’s triad, name 4 symtpoms of parkinsons
- ANS dysfunction
- anosmia
- expressionless
- dementia/depression
How would you investigate someone with suspected PD?
- Physical examination
- levodopa challenge test (do their symptoms improve with levodopa?)
How would you monitor disease progression of PD?
DaT scan
What is the first line treatment for someone whose motor symptoms are impacting their QoL?
Levodopa (often combined to reduce systemic s/e)
If someone with PD presents with motor symptoms NOT affecting QoL what are the possible treatment options?
- Dopamine agonist e.g. ropinirole or cabergoline
- levodopa
- MOA-B inhibitor
What are the side effects of parkinsons meds?
DDOOPAMINE
Dyskinesia/painful Dystonia
On-Off phenomenon
Psychosis
ABP low (postural hypotension)
Mental (gambling/addiction)
Intestines (diarrhoea)
Nausea/vomiting
Excretion (red urine)
What is Parkinson’s Disease?
Progressive loss of dopaminergic neurons from the substantia nigra
One of the roles of dopamine is controlling movement
What are 4 key features of MND?
- asymmetric limb weakness
- mixture of LMN and UMN signs
- wasting of the small hand muscles/tibialis anterior is common
- absence of sensory signs/symptoms
How would you manage someone with a TIA presenting 5 days after the event?
Within a week = 300mg aspirin (+PPI)
+ arrange for them to be seen by specialist ASAP
What should you do if someone has a TIA who is already taking aspirin?
Continue taking normal dose (do NOT give 300mg)
What should you do if you think someone had a TIA more than 7 days ago?
Refer for specialist assessment
What secondary prevention should someone who has had a stroke/TIA get?
Conservative:
- exercise/diet/stop smoking/reduce alcohol
- optimise HTN/DM treatment
Medication:
- statin
WITHOUT AF = clopidogrel 75mg
WITH AF = DOAC/warfarin
