Parkinson's Flashcards

Question

PSP

Answer 1

progressive supranuclear palsy

Answer 2

``` parkinsonism supranuclear gaze palsy pseudobulbar palsy dystonic rigidity of neck and trunk dysarthria dementia poor response to L dopa midbrain degeneration ```

Answer 3

unable to look up or down voluntarily

Answer 4

very extreme mood swing type behaviour

Answer 5

multiple system atrophy

Answer 6

``` parkinsonism autonomic failure cerebellar degeneration - poor balance pyramidal signs - spastic paraparesis and weakness sighs for no reason sleep apnoea ```

Answer 7

area affected around pons relay of all tracts is the area affected hot cross bun appearance on MRI of midbrain

Answer 8

``` no response to L dopa treatments often unlikely to be beneficial anticholinergics BP support elastic stockings bed head up fludrocortisone ```

Answer 9

45-60 0.5-1% of over 60s 2nd most common neurodegenerative disease

Answer 10

``` genetics pesticides/ herbicides pollution age men more at risk drugs ```

Answer 11

``` tremor at rest - 4-7Hz rigidity bradykinesia bilateral signs no sensory loss power is normal shuffling steps gait stooped gait with reduce arm swinging and narrow base slow, monotonous and slurred speech plain face/ facial stare reduced blinking rate depression dementia hallucinations greasy and sweaty skin heartburn dribbling dysphagia weight loss constipation ```

Answer 12

``` clinical MRI will be normal dopamine transporter imaging = unreliable and expensive handwriting anosmia violent dreams no lab tests DaT scan trial of levodopa/ apomorphine ```

Answer 13

can be seen throughout the brain | often cause co-existing dementia

Answer 14

dopamine is normally inhibitory at corpus striatum normally dopamine inhibits ACh release in corpus striatum but in Parkinson's too much ACh is released there is cell death by excitotoxcity, oxidative stress and apoptosis

Answer 15

no remission usual course = 10-15 years doesn't directly cause death puts strain on the body, increasing susceptibility to infection progression is unique to each person and rate of progression is variable

Answer 16

bronchopneumonia as a result of dysphagia

Answer 17

``` 1 - mild symptoms 2 - worsening symptoms 3 - mid-stage 4 - severe and limiting symptoms 5 - advanced and debilitating ```

Answer 18

tremor and unilateral movement symptoms | changes in posture, walking and facial expressions

Answer 19

``` tremor rigidity bilateral movement symptoms walking problems poor posture able to live alone but daily tasks are challenging ```

Answer 20

loss of balance bradykinesia falls more common impaired daily activities

Answer 21

able to stand unassisted but walked required | need support with daily activities and unable to live alone

Answer 22

``` unable to stand or walk due to stiffness wheelchair needed or bed ridden constant nursing required hallucinations and delusions motor and non-motor symptoms ```

Answer 23

Hoehn and yahr stages | unified parkinson's disease rating scale

Answer 24

monitor motor symptoms and progression

Answer 25

accounts for motor and non-motor symptoms, mental functioning, mood and social interaction accounts for cognitive difficulties, ability to carry out daily activities and treatment complications

Answer 26

``` alzheimers multi-infarct dementia repeated head injury drugs vascular events, orthostatic hypotension with atonic bladder, dementia, wilson's disease, apraxic gait parkinson's plus syndrome multi-system atrophy progressive supranuclear palsy ```

Answer 27

neuroleptics | dopamine reducing drugs - dopamine antagonists

Answer 28

Dopamine agonists L-dopa drugs that release dopamine MAO-B inhibitors

Answer 29

bind to dopamine receptors and mimic the effects of dopamine

Answer 30

dopamine precursor so increases the amount of dopamine in CNS - can cross BBB

Answer 31

selective inhibition of monoamine oxidase B which metabolises dopamine therefore increasing dopamine levels in the brain

Answer 32

efficacy decreases over time | on-off effect

Answer 33

``` nausea GI upset dyskinesia - unwanted movements psychosis impulse control disorders hypotension arrhythmia confusion disorientation insomnia nightmares ```

Answer 34

``` compulsive eating compulsive shopping hypersexuality punding pathological gambling ```

Answer 35

postural hypotension atrial fibrillation can be very serious

Answer 36

``` dry mouth dizziness urinary retention anxiety confusion tachycardia hallucinations insomnia memory problems ```

Answer 37

urinary retention acute glaucoma GI obstruction prostate problems

Answer 38

``` depression and anxiety are most common hallucinations memory problems dementia psychosis delusions impulse control disorders apathy sleep disorders panic attacks lonliness ```

Answer 39

diminished motivation and goal directed behaviour

Answer 40

``` falls balance problems paralysis vertical gaze parkinsonism cognitive impairment progressive and varying course ```

Answer 41

60-65 | 7 years survival on average

Answer 42

poorly responds to L-dopa

Answer 43

``` parkinsonism cerebellar problems autonomic problems - postural hypotension akinesia rigidity ```

Answer 44

responds poorly to L-dopa

Answer 45

degenerative neurological disorder

Answer 46

``` parkinsonism liver failure renal failure wide neurological problems parkinsonism chorea akinesia tremors rigidity personality and behavioural problems cognitive impairment ```

Answer 47

Penicillamine | treat early and can be very well controlled

Answer 48

autosomal recessive condition | causes problems with copper metabolism so copper is deposited in the liver, basal ganglia, cornea and kidneys

Answer 49

loss of activation of direct and loss of inhibition of indirect pathways