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Z Year3 Neuro Conditions > Parkinson's disease > Flashcards

Parkinson's disease Flashcards

1
Q

What is onset of Parkinson’s?

A
  1. insidious onset

2. chronic progressive

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2
Q

What is mean age on onset for Parkinson’s disease?

A

60years

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3
Q

What is the distribution for Parkinson’s?

A

asymmetrical

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4
Q

What are RF for parkinson’s disease?

A
  1. Increasing age
  2. Hx of familial PF in younger onset disease
  3. Mutation in gene encoding glucocoerberosidase
  4. MPTP exposure
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5
Q

What is the pathophysiology of Parkinson’s disease?

A
  1. Loss of dopaminergic neurons in substantia nigra

2. Lewy bodies in basal ganglia, brainstem and cortex

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6
Q

What are the signs and symptoms of Parkinson’s disease?

A
  1. Resting tremor
  2. Rigidity: cogwheel (hypertonia)
  3. Bradykineasia: slow to intiate movement
  4. Postural instability
  5. Autotomic dysfunction
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7
Q

What is the resting tremor like in PD?

A

4 to 6 Hz tremor at rest, asymmetrical, pillrolling over thumb and fingers

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8
Q

What are signs of autonomic dysfunction?

A

postural hypotension, constipation, urinary urgency and dribbling of salvia

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9
Q

What are possible DDx of PD?

A
  1. Essential tremor
  2. Progressive supranuclear palsy (PSP)
  3. Multiple system, atrophy
  4. Lewy body dementia
  5. Alzheimer’s disease with parkinsonism
  6. Drug-induced parkinsonism (symmetrical and Hx)
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10
Q

What investigation should you do in PD?

A

dopaminergic agent trial: improvement in symptoms

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11
Q

What other investigations can you consider for PD?

A
  • MRI brain to rule out structural

- If symmetrical think of other pathology

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12
Q

What is the 1st line treatment for PD?

A
  1. MAO-B inhibitor
  2. dopaminergic agent
  3. amantadine
  4. trihexyphenidyl
    e. g. levodopa or rasagiline
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13
Q

What are other possible treatments for PD?

A
  1. Deep brain stimulation (with refractory tremor)
  2. Additional Carbidopa
  3. COMT inhibitor
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14
Q

What are possible complications of PD?

A
  1. Levodopa-induced dyskinesias
  2. Motor fluctuations
  3. Dementia
  4. Constipation
  5. Psychosis
  6. Depression
  7. Anxiety
  8. Impulse control disorder
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15
Q

What is the patho of Parkinson’s disease?

A
  1. Misfolded alpha synuclein builds up

2. Lewy bodies and Lewy neutrites

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16
Q

What goes under ‘parkinsinosm’?

A
  • Parkinson’s
  • Drug induced
  • Atypical Parkinsonisms
17
Q

What are the 6 M’s of Parkinson’s?

A
  1. Monotonous, hypotonic speech
  2. Micrographia
  3. March a petit pas
  4. Misery (depression)
  5. Memory loss (dementias)
  6. HypomiMesis
18
Q

What are different types of gait?

A
  1. Ataxic
  2. Hemiplegic
  3. Scissor gate
  4. Choreiform
  5. Shuffling
19
Q

What is ataxic gait assoicated with?

A

erebellar sign, seen in Wernicke’s encephalopathy

20
Q

What is hemiplegic gait assoicated with?

A

stroke

21
Q

What is scissor gait associated with?

A

cerebral palsy

22
Q

What is choreiform gait associated with?

A

Huntington’s

23
Q

What is shuffling gait associated with?

A

Parkinsons

24
Q

What are different types of atypical parkinsonisms?

A
  1. multiple system atrophy (MSA)
  2. progressive supranuclear palsy (PSP)
  3. corticobulbar degeneration
  4. vascular parkinsonism
  5. lewy body dementia
25
Q

What is MSA associated with?

A

early autonomic and cerebellar features and Papp-Lantos bodies

26
Q

What is PSP associated with?

A

early postural instability and vertical gaze palsy

27
Q

What is corticobulbar degeneration associated with?

A

alien limb phenomenon

28
Q

What is vascular parkinson associated with?

A

Legs particularly affect and gait worse than tremor

29
Q

What is Lewy body dementia associated with?

A

early dementia and visual hallucinations

Z Year3 Neuro Conditions (34 decks)

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