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Neuro > Parkinson's > Flashcards

Parkinson's Flashcards

1
Q

What are the cardinal signs of PD?

A

tremor, rigidity, bradykinesia, postural instability

——- Other motor symptoms
- gait dysfunction
- difficulty with dual task performance
- dyskinesias

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2
Q

(true/false) PD is no longer just a motor disorder

A

true

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3
Q

What are the non-motor characteristics of PD?

A
  • cognitive dysfunction/Hallucinations
  • dementia
  • depression
  • pain
  • fatigue
  • sensory disturbance
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4
Q

(true/false) PD is the slowest growing of all neurological disorders

A

FALSE (fastest)

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5
Q

What populations have a higher prevalence of PD?

A

whites and hispanics

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6
Q

What is the average age of PD onset?

A

60-65 y/o

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7
Q

Young-onset PD is typically diagnosed between ages __-__

A

21-40

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8
Q

What is the first sign of PD in 70% of patients?

A

tremor that occurs at rest and worsens with anxiety and contralateral motor activity

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9
Q

How is PD-associated tremors differentiated from essential tremors?

A
  • presents asymmetrically
  • pill rolling
  • predominant at rest
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10
Q

What is the most characteristic feature of PD?

A

bradykinesia

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11
Q

definition: a catching and releasing throughout the range of motion

A

cogwheel ridigity

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12
Q

definition: refers to a slow and sustained contraction during range of motion

A

lead pipe rigidity

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13
Q

When does bradykinesia increase?

A

With contralateral motor activity or mental task performance

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14
Q

What is the hallmark of PD and is one of the earliest functional limitations identified by patients?

A

gait dysfunction

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15
Q

Do abnormal involuntary movements occur during the on or off period of the medication cycle?

A

on period
–> involve the head, trunk, limbs, and sometimes the muscles of respiration

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16
Q

definition: as PD progresses, a phenomenon called the “on-off” or “wearing off” phenomenon in which symptoms wax and wane

A

dyskinesias

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17
Q

Are freezing episodes more severe in the on or off state of the medication cycle?

A

off state

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18
Q

What autonomic disorders commonly occur with PD?

A
  • urinary incontinence
  • symptomatic postural hypotension
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19
Q

Pain has been identified in as many as ___% of patients with PD.

A

80%

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20
Q

What are the categories of PD?

A
  • postural instability and gait disorder-predominant (PIGD)
  • tremor predominant
  • mixed
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21
Q

The ____ subtype of PD has FASTER disease progression, greater occupational disability, more intellectual impairment, higher likelihood of depression, and lack of motivation. They score as more impaired than tremor-predominant patients on the Activities of Daily Living subscale of the Unified Parkinson’s Disease Rating Scale (UPDRS).

A

PGID

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22
Q

Progression of symptoms typically is (slower/faster) for the tremor dominant subgroup

A

slower

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23
Q

(true/false) In the majority of cases, the cause of PD cannot be identified

A

true

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24
Q

The best understood environmental cause of PD is _______.

A

encephalitis

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25
Q

Drug induced parkinsonism can also result from some ______ medications

A

neuroleptic

26
Q

Cigarette smoking may (decrease/increase) the risk of PD

A

decrease –> possibly because carbon monoxide is a free radical scavenger

27
Q

Confirmation of PD is only via ___.

A

autopsy

28
Q

What criteria should you follow for clinical diagnosis of PD?

A
  1. clinically possible if the patient has a resting tremor, asymmetric rigidity, or asymmetric bradykinesia;
  2. clinically probable if the patient has any 2 of the above symptoms; and
  3. definite if, in addition, there is a definitive response to anti-parkinsonian drugs.
29
Q

PD has long been associated with loss of _______ cells in the substantia nigra of the midbrain…. however, the site of action of this neurotransmitter loss is in the basal ganglia

A

dopamine-producing

30
Q

Dopamine is normally transmitted by way of nigrostriatal neurons from the brainstem to the ____

A

basal ganglia

31
Q

Current theory of PD is that the progressive loss of nigrostriatal neurons is accompanied by an increase in ____ cells in the substantia nigra and a loss of ____.

A

increased glial cells; loss of neuromelanin

32
Q

What in non-motor areas may account for the non-motor symptoms associated with PD?

A

Lewy bodies of surviving nigrostriatal neurons

33
Q

(true/false) All pharmacological agents used to treat people with PD ARE NOT associated with significant side effects

A

FALSE (they are)

gastrointestinal (eg, nausea, vomiting, constipation)
CNS (eg, confusion, delirium, hallucinations, behavioral changes)
neurologic (eg, dyskinesias, dystonias)
cardiovascular (eg, orthostatic hypotension, dysrhythmias)

34
Q

Motor symptoms become too disabling if patient is in the (on/off) state for too long during the day

A

off state

35
Q

Current surgical methods rely on ______ of deep brain structures

A

e-stim

36
Q

The sites for deep brain stimulation (DBS) include the _____ or ____.

A

globus pallidus or subthalamic nuclei

37
Q

Modified H & Y scale stage ___: no signs of disease

A

0

38
Q

modified H & Y scale stage ___: unilateral disease

A

1

39
Q

Modified H & Y scale stage ___: unilateral plus axial involvement

A

1.5

40
Q

Modified H & Y scale stage ___: bilateral disease without impairment of balance

A

2

41
Q

Modified H & Y scale stage ___: mild bilateral disease; recovery on the pull test

A

2.5

42
Q

Modified H & Y scale stage ___: mild-moderate bilateral disease, some postural instability; physically independent

A

3

43
Q

Modified H & Y scale stage ___: severe disability but able to walk or stand unassisted

A

4

44
Q

Modified H & Y scale stage ___: WC bound or bedridden unless receiving aid from someone

A

5

45
Q

Those who undergo DBS can only improve to their best (on/off) state condition prior to the DBS

A

on state

46
Q

What surgical management intervention addresses the symptoms of the disease but does not affect the progression of the disease?

A

DBS (deep brain stimulation)

–> therefore, those symptoms not addressed by the DBS will continue to worsen over time

47
Q

What are adverse effects of DBS?

A
  • dysarthria (9.3%)
  • weight gain (8.4%)
  • miscellaneous motor (4.0%)
  • intracranial hemorrhage (3.9%)
  • psychiatric (3.5%)
  • stimulation-induced dyskinesia (2.6%)
48
Q

What H & Y stages of PD will benefit from physical intervention?

A

stages 1-3

–> however optimal frequency and intensity are not yet determined

49
Q

Original H & Y scale stage ___: unilateral involvement with no or minimal functional involvement

A

1

50
Q

Original H & Y scale stage ___: bilateral or midline involvement without impairment of balance

A

2

51
Q

Original H & Y scale stage ___: impaired righting reflexes with some restriction in functional activity, but with the capacity for living independently

A

3

52
Q

Original H & Y scale stage ___: severely incapacitating disease but ale to walk and stand independently

A

4

53
Q

Original H & Y scale stage ___: confined to bed and WC unless receiving assistance

A

5

54
Q

Compared to shorter format LSVT-BIG or general exercise, LSVT-BIG was (less/more) effective at improving motor function.

A

more effective

55
Q

(true/false) Most of the available studies on physical interventions have focused on people in early and mid stages of PD

A

true

56
Q

What are the parameters for LSVT BIG?

A

4 consecutive days x 60 minutes x 4 weeks

57
Q

(true/false) Tests that are predictive of falls in the general population have comparable sensitivity and specificity for people with PD

A

FALSE (they do not)

58
Q

What scale provides a quick and easy method to identify the general stage of PD

A

H & Y

59
Q

What scale is considered as the gold standard for quantifying signs and symptoms of PD?

A

Unified Parkinson’s Disease Rating Scale (UPDRS)

60
Q

What outcome measures are used for QOL in patients with PD?

A

PDQ-39
Parkinson’s Disease Quality of Life Questionnaire (PDQL)

Neuro (45 decks)

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