Parkinson's

Question 1

4 Components of PD Def

Answer 1

Neurodegenerative, slowly progressing, synuclein accumulation, characterized by hypokinetic movement disorder

Question 2

Diagnostic Criteria (4)

Answer 2

Bradykinesia, w/ at least one of: Tremor at rest, rigidity, loss of postural reflexes

Question 3

Nonmotor Features

Answer 3

Things like autonomic dysfunction/sleep disturbance/smell loss/constipation from multisystem NT loss can appear decades before clinical onset

Question 4

Freezing

Answer 4

Most disabling symptom of PD, motor blocks leading to only very small slow movements

Question 5

2 Main Kinds of PD

Answer 5

Tremor Dominant - good prognosis, responds well to treatment for a long time
Non-Tremor Dominant - more rapid, early gait impairment and other motor systems

Question 6

Parkinsonism

Answer 6

Not quite Not quite PD, instead like it. Can be secondary to other things like stroking out BG or drug use affecting DA. Normally tauopathy, not synuclein

Question 7

DAT Imaging

Answer 7

Shows reduced presyanptic stuff

Question 8

Vulnerability of Striato-nigral Neurons

Answer 8

DA predisposes to oxidative stress, so get mt depletion and synuclein aggregation

Question 9

Lewy Bodies

Answer 9

Eosinophilic cytoplasmic inclusions that show where PD has spread to in brain

Question 10

Braak Staging (3)

Answer 10

1/2 is autonomic/olfactory, 3/4 is sleep and motor, 5/6 is all throughout brain and get emotional/cognitive disturbances. Lewy bodies spread to these places

Question 11

PD Physiology

Answer 11

Increased firing from STN/Gi (greater indirect) bc less DA firing from STN

Question 12

4 Treatment Stages

Answer 12

Honeymoon period
Motor complication period
Resistant symptoms
Cognitive decline period

Question 13

Carbidopa

Answer 13

Carboxylase inhibitor, prevents conversion of L-Dopa to DA to avoid huge influx w/ side effects

Question 14

2 Dopa Sparing Strategies for Early PD

Answer 14

MAO Inhibitors Type B
DA Agonists (ropinerole, delay L-Dopa dyskinesia)

Question 15

2 Motor Complications from L-Dopa

Answer 15

Dyskinesia

Wearing Off - symptoms reoccur b/w doses

Question 16

Deep Brain Stimulation

Answer 16

Of subthalamic nucleus, used in honeymoon period or when motor complications occur w/ normal treatment (dyskinesia, wearing off)