Parkinson Disease

Question 1

type of symptoms common in elderly patients

Answer 1

extrapyramidal symptoms

Question 2

what age group is affected more in parkinson disease

Answer 2

males

Question 3

what two things are thought to be protective against parkinson disease

Answer 3

smoking and caffeine

Question 4

what are the risk factors for oxidative damage in parkinson disease

Answer 4

high content of lipids
brain uses 20% of total oxygen demand
brain has few protective mechanisms
brain is post mitotic
brain contains large amounts of iron

Question 5

what are the pathological features of parkinson disease

Answer 5

lewy bodies
neuronal loss
depigmentation of substania nigra, lucus ceruleus and the dorsal vagal nucleus

Question 6

what type of tremor is characteristic of parkinson

Answer 6

4-6 Hz resting, pill rolling worse with stress

Question 7

rachet like rigidity or cogwheel rigidity

Answer 7

parkinson disease

Question 8

type of gain associated with parkinson

Answer 8

festinating gait (shuffling gait)

Question 9

type of drug selegiline is

Answer 9

monoamine oxidase B inhibitor

Question 10

selegiline should be avoided with

Answer 10

meperidinem tricyclic antidepressants or serotonin reuptake inhibitors

Question 11

selegiline is metabolized into

Answer 11

amphetamine

Question 12

what are the three comonly used anticholingergic medications

Answer 12

benzotropine, biperiden, and trihexyphenidyl

Question 13

what are the anticholinergic medications used or

Answer 13

may hep with tremor and rigidity

Question 14

what population should be carefully assessed when treating with anticholinergics

Answer 14

elderly

Question 15

______can help symptoms for up to 6 months

Answer 15

amantadine

Question 16

_______has a weak dopaminergic effect

Answer 16

amantadine

Question 17

____-is better tolerated in the elderly than anticholingeric medications

Answer 17

amantadine

Question 18

what are the side effects of amantadine

Answer 18

confusion, skin rash, nightmares and hallucinations

Question 19

dopamine agonists have an advantage because they do not

Answer 19

require intact substantia nigra and can be used early in the disease sparing the use of levodopa

Question 20

what are the side effects of dopamine agonsits

Answer 20

nausea hallucinations and confusion

Question 21

examples of dopamine agonists

Answer 21

bromocriptine
pergolide
ropinrole
pramipexole
ritigotine
carbergoline

Question 22

what are the 2 COMT inhibitors

Answer 22

tolcapone and entacapone

Question 23

___–enhances levodopa effectiveness

Answer 23

COMT inhibitors like tolcapone and entacopone

Question 24

possible dangerous side effect of COMT inhibitors

Answer 24

liver toxicity

Question 25

what is the MOST effective symptomatic drug for parkinson's disease

Answer 25

levodopa therapy

Question 26

side effects of levodopa therapy

Answer 26

nausea, hypotension, dyskinesia (receptor hypersensiivity), mental status changes

Question 27

what are the surgical options for parkinson

Answer 27

pallidotomy/thalamotomy fetal cell and adrenal transplants pacemaker placement in subthalamic nuclues

Question 28

progessive supranucleuar palsy affects girls or boys more

Answer 28

males

Question 29

what are the clinical features of PSP

Answer 29

``` supranucleuar ophthalmoplegia unusual to have tremor axial dystonia rigidity bradykinesia pseudobulbar signs dementia babinksi signs hperreflexia ```

Question 30

how is PSP diagnosed

Answer 30

history and physical

Question 31

is there a treatment for PSP

Answer 31

no treatment, die within 10 years