Parkinson’s Disease Flashcards
1
Q
Pathophysiology of Parkinson’s disease
A
Progressive reduction of dopamine in the basal ganglia particularly the substantial nigra causing disorders of movement
2
Q
Parkinson’s triad
A
Resting tremor (pill rolling)
Rigidity
Bradykinesia
3
Q
Presentation of a Parkinson’s disease
A
Older aged man ~ 70 yo
Stopped posture Forward tilt Shuffling gait Reduced arm swing Unilateral tremor - pill rolling (worse at rest) Cogwheel rigidity Bradykinesia Micrographia Hypomimia - reduced facial expressions
4
Q
Other conditions associated with Parkinson’s disease
A
Depression Sleep disturbances and insomnia Anosmia Postural instability Cognitive impairment and memory loss
5
Q
Differential for Parkinson’s disease
A
Dementia with Lewy Bodies
6
Q
How to diagnose Parkinson’s disease
A
UK Parkinson’s disease society brain bank clinical diagnostic criteria
- history and examination
7
Q
Management of Parkinson’s disease
A
Controlling symptoms:
- Levodopa - synthetic dopamine
- Carbidopa or benserazide - decarboxylase inhibitor - stops break down if levodopa
- Entacapone- COMT inhibitor - stops break down of levodopa
- dopamine agonists - cabergoline, pergolide and bromocryptine
- Monoamine oxidase B inhibitors - selegiline, rasagiline- prevent breakdown of dopamine
8
Q
Side effects of Levodopa
A
Dyskinesia - dystonia, chorea or athetosis
9
Q
Side effect of dopamine agonists
A
Prolonged use can cause pulmonary fibrosis
