Parkinson's disease

Question 1

1. What is the pathological hallmark of Parkinson’s?
2. What causes this gross appearance?
3. What is the neurohistological hallmark of PD?

Answer 1

1. Loss of the normally dark black pigment of the substantia nigra and Locus Coeruleus
2. Pigment loss correlates with dopaminergic cell loss
3. Lewy bodies

Question 2

1. Identify the 4 main motor symptoms of PD.
2. Identify some non-motor symptoms.
3. What characterises the gait of PD patients?

Answer 2

1. Bradykinesia, Rigidity (cogwheel or lead pipe), Postural instability and gait impairment, Resting tremor
2. Sleep disorders, Hallucinations, Gastrointestinal dysfunction, Depression, Cognitive impairment / dementia, Anosmia
3. Shuffling, short-stepped gait (+/- festination)

Question 3

1. Name the scan that may be used to aid PD diagnosis
2. What are the three largest risk factors for PD?
3. ____% of PD cases are idiopathic and ____% are familial.

Answer 3

1. DaTSCAN
2. Advancing age, Family history, male gender.
3. 95% idiopathic and 5% familial

Question 4

1. Name two monogenetic forms of PD
2. Treatment of Parkinson’s disease is _________.
3. Name the three main drugs used in the treatment of the motor symptoms of PD

Answer 4

1. LRRK2 and PARKIN gene mutations
2. Symptomatic
3. Levodopa, Dopamine agonists, Monoamine oxidase-B inhibitors

Question 5

1. Describe the signs embraced by the term bradykinesia

Answer 5

1. Slowness of movement, hypomimia, hypophonia, Micographia