PARKINSON Flashcards
What is the second most common age-related neurodegenerative disease?
A) Alzheimer’s disease
B) Parkinson’s disease
C) Huntington’s disease
D) Multiple sclerosis
Answer: B) Parkinson’s disease
Rationale: Parkinson’s disease (PD) is the second most common neurodegenerative disease, after Alzheimer’s disease. It primarily affects movement due to dopamine depletion.
What is the hallmark pathological feature of Parkinson’s disease?
A) Beta-amyloid plaques
B) Lewy bodies and Lewy neurites
C) Tau protein tangles
D) Demyelination of neurons
Answer: B) Lewy bodies and Lewy neurites
Rationale: PD is characterized by the accumulation of Lewy bodies and Lewy neurites, which contain α-synuclein, leading to the degeneration of dopaminergic neurons in the substantia nigra pars compacta.
What is the most common initial symptom of Parkinson’s disease?
A) Bradykinesia
B) Rest tremor
C) Postural instability
D) Cognitive impairment
Answer: B) Rest tremor
Rationale: The first symptom of PD is often a resting tremor, typically unilateral at onset. Over time, other motor symptoms such as rigidity and bradykinesia become more prominent.
Which part of the brain primarily degenerates in Parkinson’s disease?
A) Hippocampus
B) Substantia nigra pars compacta
C) Cerebellum
D) Prefrontal cortex
Answer: B) Substantia nigra pars compacta
Rationale: PD is caused by the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced dopamine levels in the striatum.
What type of tremor is most characteristic of Parkinson’s disease?
A) Intention tremor
B) Postural tremor
C) Resting tremor
D) Essential tremor
Answer: C) Resting tremor
Rationale: PD is associated with a resting tremor, meaning the tremor occurs when the affected limb is at rest and improves with movement.
What neurotransmitter is primarily deficient in Parkinson’s disease?
A) Acetylcholine
B) Glutamate
C) Dopamine
D) Serotonin
Answer: C) Dopamine
Rationale: PD is characterized by a deficiency of dopamine due to the degeneration of neurons in the substantia nigra.
What is the gold standard treatment for Parkinson’s disease?
A) Dopamine agonists
B) Anticholinergic drugs
C) Levodopa
D) MAO-B inhibitors
Answer: C) Levodopa
Rationale: Levodopa, often combined with a decarboxylase inhibitor (e.g., carbidopa), is the most effective treatment for PD and helps replenish dopamine levels.
Why is levodopa administered with a peripheral decarboxylase inhibitor?
A) To enhance its absorption
B) To reduce its peripheral metabolism and side effects
C) To increase dopamine production in the brain
D) To prevent neurotoxicity
Answer: B) To reduce its peripheral metabolism and side effects
Rationale: Levodopa is converted to dopamine in the periphery, causing nausea, vomiting, and hypotension. A decarboxylase inhibitor like carbidopa prevents this conversion, allowing more levodopa to reach the brain.
What imaging technique is used to assess dopamine function in Parkinson’s disease?
A) MRI
B) CT scan
C) PET or SPECT scan
D) EEG
Answer: C) PET or SPECT scan
Rationale: PET or SPECT imaging can detect reduced uptake of dopaminergic markers, especially in the posterior putamen, aiding in PD diagnosis.
Which symptom is most specific to Parkinson’s disease and helps differentiate it from other parkinsonian syndromes?
A) Symmetric onset of motor symptoms
B) Poor response to levodopa
C) Asymmetric onset with rest tremor
D) Early cognitive decline
Answer: C) Asymmetric onset with rest tremor
Rationale: Parkinson’s disease typically presents with an asymmetric onset of motor symptoms, often starting with a rest tremor on one side. Other parkinsonian syndromes usually show symmetric symptoms and poor response to levodopa.
Which of the following statements about Parkinson’s disease is TRUE?
A) The mean age of onset is 40 years
B) Parkinsonism refers only to idiopathic Parkinson’s disease
C) Postural instability occurs early in the disease
D) The diagnosis is mainly clinical
Answer: D) The diagnosis is mainly clinical
Rationale: PD is primarily diagnosed based on clinical symptoms such as bradykinesia, tremor, and rigidity. Imaging can support but does not confirm the diagnosis.
Which of the following drugs is used to increase dopamine release and has mild anti-Parkinsonian effects?
A) Amantadine
B) Donepezil
C) Rivastigmine
D) Riluzole
Answer: A) Amantadine
Rationale: Amantadine increases dopamine release and has mild anti-Parkinsonian effects, sometimes used for early symptoms or levodopa-induced dyskinesias.
Which symptom typically appears in later stages of Parkinson’s disease?
A) Bradykinesia
B) Tremor
C) Dementia
D) Rigidity
Answer: C) Dementia
Rationale: Cognitive impairment and dementia generally develop in later stages of Parkinson’s disease, often associated with Lewy body pathology.
What is the lifetime risk of developing Parkinson’s disease in men?
A) 1%
B) 3%
C) 5%
D) 7%
Answer: B) 3%
Rationale: The lifetime risk of developing PD is approximately 3% for men and 2% for women.
