NEURO 3

Question 1

triad of motor features in parkinson’s

Answer 1

bradykinesia, rigidity and tremor

Question 2

non motor features in parkinson’s

Answer 2

olfactory dysf - loss of smell, cogni imp, psych, autonomic dysf, pain and fatigue, RBD

Question 3

what is rapid eye movement sleep disorder

Answer 3

abn behaious during rapid eye movement sleep - related to dream enactment

Question 4

RBD and PDx

Answer 4

together - severe autonomic dysf, gait impairment and dementia
just RBD - increased risk of developing neurodegenerative condition

Question 5

resting tremor

Answer 5

3-5Hz

Question 6

frements

Answer 6

rigidity by voluntary movement of other body parts

Question 7

what can happen if medications are not absorbed properly in parsons

Answer 7

increased risk of acute akinesia/neuroepileptic malignant syndrome - take a drug holiday

Question 8

dopamine agonists examples and which drugs need investigations before they can be initiated and why

Answer 8

ropinerole, pramiperole, apomorphine
bromocriptine, cabergoline - ECHO, ESR, CXR
pulmonary , retroperitoneal and cardiac fibrosis

Question 9

why shouldnt DA be prescribed in elderly and confused px

Answer 9

SE include hallucinations

Question 10

what is given along with levodopa and why

Answer 10

cabidopa/berverazide to prevent peripheral metabolism of levodopa into dopamine

Question 11

reddish colour on standing

Answer 11

levodopa

Question 12

what can happen at peak concentrations of leveopa

Answer 12

beginning and end of dose - chloroform/dystonic movements - biphasic dyskinesia

Question 13

fluctuations

Answer 13

add DA/MAOBI (sergelline), COMTI (enalapore/tolapore)

Question 14

psychosis

Answer 14

clozapine

quetiapine

Question 15

depression

Answer 15

antidep

Question 16

visual hallucinations/delusions in dementia

late stage dementia

Answer 16

rivastigamine

Question 17

other options for side effects of levodopa

Answer 17

direct delivery of stable levodopa
carbiopa gel
duodepal - in dueodenum

Question 18

other optiosn for side effects of DA

Answer 18

subcut infusion of potent DA - apomorphine

Question 19

excessive sleepiness

Answer 19

don’t drive
adjust meds
modafenil

Question 20

constipation
GI motility
fatigue
hypotentsion

Answer 20

polythyleneglyco/lubiprostone
domperidone
methypheindate
meds review. midodrine, clomperidone, fludrostinoma, pyridogmistigive

Question 21

parkinsonism - 6

Answer 21

vascular 
drug induced 
multisystem 
progressive supranuclear
fragile X tremore ataxia syndrome 
essential tremor

Question 22

vascular

Answer 22

lower body predom

Question 23

drug induced

Answer 23

symmetry coarse postural tremor

Question 24

multisystem

Answer 24

autonomic dysf
cerebellar symp
parkinsonism
hot cross bun sign

Question 25

progressive supra nuclear palsy

Answer 25

symm
akinetic rigid synd with predominantly axial involevemtn
gait and balance imp

Question 26

FXTAS

Answer 26

cerebellar signs
parkinsonism
autonomic
prom ovarian failure. early menopause

Question 27

ET

Answer 27

ADom
12Hz
commonest cause of head tremor
improved by alcohol and rest, propranolol, primidone