Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sub Acute Final Prep Sean > Parkinson's > Flashcards

Parkinson's Flashcards

1
Q

Parkinson’s Facts

A

Progress degenerative disease (slow decline). Patients have difficulty making automatic movements

Mean age of onset: early to mid 60s

more common in men > women (3:2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mean age of onset of PD

A

early to mid 60s
prevalence 1/100 in >60y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk of young onset of PD

A

5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is PD more common in men or women

A

more common in men (3:2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors of PD

A

multifactorial - interplay between many factors

Age (increases exponentially until 80 y/o)

Gender

Pesticide exposure

Prior head injuries/concussion

Family history

Lewy bodies form in Substantia Nigra: could be causative or protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pathophysiology of PD

A

Problem to the basal ganglia where movements are refined

Impacts the inhibition and excitation of movements which causes deficits in coordination and smoothness of movements

Can have difficulty initiating movement and increasing movement through direct and indirect pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology of PD in direct pathway

A

Difficulty initiating movement

Not enough excitation/planning to initiate movement

Not increasing signals enough to initiate movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathophysiology of PD in indirect pathway

A

difficulty increasing movement

difficulty inhibiting unwanted movements like tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Early symptoms of PD

A

Vague and non-specific
inexplicable tiredness
unwarranted fatigability
mild muscular aches and cramps
cognitive impairment affecting executive function and memory
depression

bradykinesia (slowness of movement), rigidity, tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Progressed symptoms of PD

A

Tremor resulting in spills of food/drink
Speech difficulties
reduced facial expression
possible drooling
difficulty initiating movement
freezing on social outings

postural instability, falls, freezing, dysphagia (difficulty swallowing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Timeframe of PD symptoms

A

symptoms may appear up to 20 years before diagnosis and may extend to 20 years after diagnosis

increasing severity of symptoms and disability over time

Starts with mild non-motor symptoms, progresses to motor symptoms and ultimately leads to severe disability in the advanced stages due to motor and non-motor complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of PD before diagnosis

A

constipation, depression, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Primary impairments of PD (motor, non-motor)

A

Motor
- bradykinesia
- hypokinesia
- akinesia
- decreased postural stability
- tremor (resting/action)
- rigidity

Non-motor
- decreased autonomic function
- decreased sensory function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Secondary impairments of PD (motor, non-motor)

A

Motor
- Dyskinesia
- Dystonia

Non-motor
- neuropsychiatric features
- sleep problems
- pain
- fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is bradykinesia

A

slowness of movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hypokinesia

A

Small amplitude of movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is akinesia

A

Difficulty initiating/maintaining movement
Absence of movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is freezing

A

Difficulty starting or continuing movements - speech, handwriting, gait

Freezing of gait - episodic gait disturbance

Typically see festination prior to freezing: progressive shortening of stride length and increasing cadence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a resting tremor for PD

A

involuntary, rhythmic movement of a body part (4-6Hz): typically hands, feet, lips, chin affected

small frequency, small range

suppressed by voluntary activity - sleep and complete relaxation

20
Q

What can rigidity be increased by

A

stress/anxiety

21
Q

Why do the secondary motor impairments (dyskinesia, dystonia) occur in PD

A

occur after taking dopamine replacement medication for an extended period

22
Q

What is dyskinesia

A

involuntary movement
- can occur in head or trunk

23
Q

What is dystonia

A

often in the plantarflexors or wrist flexors

Continuous or repetitive muscle twisting/spasm

24
Q

What is the difference between tremor and dyskinesia

A

Tremor is a primary impairment, caused by the loss of dopamine in the BG from PD. It is typically the first sign of PD, with regular direction and amplitude. At rest 4-6Hz.

Dyskinesia is a secondary impairment indirectly caused by PD medication, so takes a while to develop. Irregular in direction and amplitude (1-4Hz)

25
Q

What is the difference between PD and conditions similar to PD (Atypical Parkinsonism or Parkinson-plus syndromes) Supranuclear palsy, multiple system atrophy, corticobasal degeneration

A

These conditions don’t respond to dopaminergic treatments and have a worse prognosis than PD

26
Q

What scale is used for PD disease severity

A

Hoehn and Yahr Scale
Stage 1 and 2 (Mild) - Early PD
Stage 3 (moderate) - mid stage PD
Stage 4 and 5 (severe) - advanced PD

27
Q

What is current management like for PD

A

No cure for PD
Current therapies aim to treat the symptoms of the disease
Management is multidisciplinary - medical and non-medical

28
Q

Physio management of PD focuses on…

A

Balance and motor function/skill

29
Q

What is the most successful way to treat PD symptoms

A

Drug management

30
Q

What does levadopa do for PD

A

Levadopa is a dopamine replacement agent for the treatment of PD. This helps to control bradykinetic symptoms

Problems: after 5-10 years it starts to wear off, dyskinesia, depression, nausea

31
Q

What do dopamine agonists do for PD

A

Mimics dopamine in the brain
Can be given alone or with L-dopa

side effects: nausea and postural hypotension

32
Q

What do monoamine oxidase type B inhibitors do

A

cause dopamine to accumulate in surviving nerve cells and reduce the symptoms of PD

side effects: confusion or delirium

33
Q

What do Catechol-O-methyltransferase (COMT) inhibitors do?

A

Prologue L-dopa’s effects by preventing the breakdown of dopamine

side effects: urine discolouration, diarrhoea, abdominal pain

34
Q

What do anticholinergics do?

A

effective for tremor

side effects: memory impairment, confusion and psychosis, dry mouth

35
Q

What does amantadine do

A

Reduce symptoms and dyskinesia. It is often used alone in PD early stages

36
Q

What drug is effective for tremor in PD

A

Anticholinergics

37
Q

What drug is used in early stage PD

A

Amantadine

38
Q

When would you use surgical management (targeted gene therapy, stem cell transplantation, deep brain stimulation) for PD

A

when patients can’t deal with the side effects of the drugs

39
Q

What are the different surgical management options for PD

A

Targeted gene therapy
Stem cell transplantation
Deep brain stimulation

40
Q

What is deep brain stimulation

A

like a pacemaker for motor control

most common surgical treatment in PD

Eases symptoms/reduce medication needs

Used for motor problems

41
Q

Physiotherapy management of PD

A

main goal of physio management is to prolong activities, independence, balance and ability to walk for as long as possible

Cueing and attentional cognitive strategies to help initiate movements and maintain movements and reduce bradykinesia and hypokinesia. E.g. taping, metronome

Task specific training - part and whole task

Falls prevention: balance training, home modifications, multifactorial interventions, prescription of aids and equipment

General exercise: treadmill, training, dance, martial arts
- helps delay progression of neurological diseases. Neuroprotective effects

42
Q

main goal of physiotherapy management in PD

A

main goal of physio management is to prolong activities, independence, balance and ability to walk for as long as possible

43
Q

Why is cueing and attentional strategies important for PD patients

A

help to initiate and maintain movements

reduce or avoid freezing from happening

44
Q

What a PD falls prevention treatment plan would look like (Morris et al)

A

Progressive resistance strength training or movement strategy training (mobility, balance during functional tasks) + education focused on falls risk and prevention + cueing strategies if freezing occurred

PD-WEBB program

45
Q

LSVT-BIG for PD

A

focuses on amplitude of movement rather than speed

aims to restore normal movement amplitude by recalibrating a patients sensory perception of movement

46
Q

Discuss role of other health practitioners in management of patients with PD

A

OT: assist with ADL’s
Speech therapist: help with communication and swallowing issues
Neurologists: manage medication
Dietician: nutritional needs
Social workers: social aspects
Psychologists: mental health

Sub Acute Final Prep Sean (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions