Parkinson's

Question 1

Parkinson’s is a chronic progressive disease characterized by ________________.

Answer 1

rigidity
bradykinesia
tremor
postural instability (later stages)

Question 2

What are the types of PD?

Answer 2

Idiopathic
Secondary

Question 3

What is the most common form of PD?

Answer 3

Idiopathic

Question 4

What are potential risk factors of PD?

Answer 4

genetic marker
family history

Question 5

What part of the basal ganglia is damaged in PD?

Answer 5

pars compacta

Question 6

What does damage to the basal ganglia cause?

Answer 6

slow movement
decreased ability to adapt to changes in environment
decreased coordination

Question 7

What is the hallmark of PD?

Answer 7

cogwheel rigidity

Question 8

Degeneration of substantia nigra leads to deficiency in ____________ production.

Answer 8

dopamine

Question 9

What are early signs/symptoms of PD?

Answer 9

movement disorder of hand
slowness of movement
shuffling gait

Question 10

What is the primary motor loop?

Answer 10

loss of dopamine in SN
decreased inhibition of striatum
less output to internal GP and more output to external GP
internal GP provides more inhibition to thalamus, brain stem, spinal cord
External GP provides less inhibition of subthalamic nuclei
increased output of subthalamic nuclei
increased excitation of internal GP
furthered inhibition of internal GP

Question 11

What is the secondary loop?

Answer 11

frontal lobe gives direct input to subthalamic nuclei
facilitation of internal GP
output is inhibitory to thalamus, brainstem and spinal cord
double inhibition

Question 12

How do PD pts usually die?

Answer 12

respiratory dysfunction

becomes pulmonary restrictive disease

Question 13

Why is a mask like appearance an early sign of PD?

Answer 13

face takes up lots of space on homunculus and requires more dopamine

Question 14

What is the early tremor typically seen with PD?

Answer 14

Pill rolling

Question 15

Motor planning deficits result in ______________.

Answer 15

bradykinesia/akinesia
difficulty with dual task control

Question 16

Postural/gait characteristics of PD

Answer 16

stooped posture
poor balance
shuffling gait
difficulty starting AND stopping movement

Question 17

How is PD diagnosed?

Answer 17

clear response to Levadopa

pt must present with at least two of four cardinal features

Question 18

What is the Hoehn-Yahr Scale?

Answer 18

Stage I - minimal to no symptoms (unilateral if present)
Stage II - minimal B or midline sx, balance not impaired
Stage III - Stage II with impaired balance
Stage IV - All sx present and severe needs assistance to ambulate
Stage V - Wheelchair bound or bedridden

Question 19

What are medical treatment options for PD?

Answer 19

pharmacology
deep brain stimulation
surgery
tissue transplant

Question 20

Why is levadopa often help until pt is 70?

Answer 20

people build tolerance so longer you go without meds, the longer you get to use it in later stages

Question 21

What is sinemet?

Answer 21

contains both levadopa and carbidopa

Question 22

When would deep brain stimulation be indicated?

Answer 22

in later stages– pharmacologic resistant motor deficits

Question 23

If a patient presents with a tremor first (opposed to pill rolling) a _____________ course is expected.

Answer 23

slower