Parkinson's Disease

Question 1

Parkinson’s Disease is a sudden disease

True or False

Answer 1

False. It is a progressive disease

Question 2

Parkinson’s Disease can lead to the development of dementia

True or False

Answer 2

True, dementia is developed in the late stages of the disease

Question 3

What are the symptoms of Parkinson’s Disease? SATA

a. tremor
b. rigidity
c. bradykinesia
d. wide shuffling step
e. postural instability

Answer 3

a. tremor
b. rigidity
c. bradykinesia
e. postural instability

Question 4

Parkinson’s Disease is due to increased dopamine

True or False

Answer 4

False

Question 5

What are the key characteristics of Parkinson’s Disease?

Answer 5

tremor, rigidity, akinesia/bradykinesia, and postural changes

Question 6

What term is used to describe the clinical syndrome resulting from degenerative changes in basal ganglia function other than PD?

Answer 6

parkinsonism

Question 7

What are some potential causes of Parkinsonism other than PD?

Answer 7

• postencephalitic syndrome
• side effects of antipsychotic drugs that block dopamine receptors
• toxic reactions to chemical agents
• severe carbon monoxide poisoning

Question 8

What is the primary brain abnormality associated with Parkinson’s Disease?

Answer 8

degeneration of pigmented nigrostriatal dopamine neurons

Question 9

What age does Parkinson’s Disease in the United States typically onset?

Answer 9

PD commonly starts to manifest around the age of 57

Question 10

What factors are believed to contribute to the development of Parkinson’s Disease?

Answer 10

genetic and environmental factors

Question 11

Are there specific environmental factors associated with an increased risk of Parkinson’s Disease?

Answer 11

Yes, exposure to certain agricultural pesticides, rural living with private wells in areas that have been sprayed with herbicides and pesticides have an elevated risk of PD.

Question 12

What is the most noticeable manifestation of Parkinson’s Disease, and which body parts are typically affected?

Answer 12

The most visible manifestation of PD is tremor, which often affects the hands and feet, head, neck, face, lips, and tongue, or the jaw

Question 13

Describe the characteristics of the tremor associated with Parkinson’s Disease.

Answer 13

rhythmic, alternating flexion and contraction movements, resembling the motion of rolling a pill between the thumb and forefinger. It occurs at a rate of 4 to 6 beats per minute and initially appears unilaterally (on one side), happens when the limb is at rest and supported.

Question 14

What is rigidity, and how does it manifest in individuals with Parkinson’s Disease?

Answer 14

Rigidity refers to the resistance encountered during joint movement, affecting both flexors and extensors throughout the entire range of motion. It is most noticeable when passive joint movement occurs and involves jerky, ratchet-like movements that require significant effort to perform. Initially unilateral, rigidity also progresses to affect both sides of the body.

Question 15

What is bradykinesia, and how does it impact individuals with Parkinson’s Disease?

Answer 15

Bradykinesia is the slowness in initiating and executing voluntary movements, making it difficult to stop movements suddenly. People with bradykinesia may experience freezing while walking, have difficulty changing their stride, and exhibit a shuffling gait without swinging their arms.

Question 16

How does Parkinson’s Disease affect facial expressions and speech?

Answer 16

As PD progresses, individuals may experience limited and slow emotional and voluntary facial movements, resulting in a stiff and mask-like facial expression. There is also a loss of the blinking reflex and a failure to express emotions. Speech becomes slow, monotonous, poorly articulated, and lacks modulation.

Question 17

What are some autonomic symptoms associated with Parkinson’s Disease?

Answer 17

PD can affect the autonomic nervous system, leading to symptoms such as excessive sweating, increased sebaceous gland secretion, and salivation. Autonomic symptoms may include lacrimation, dysphagia, orthostatic hypotension, thermal regulation issues, constipation, impotence, and urinary incontinence, particularly in the later stages of the disease.

Question 18

Is cognitive dysfunction a common feature of Parkinson’s Disease, and what types of cognitive deficits are typically observed?

Answer 18

Yes, cognitive dysfunction can be a significant feature in PD. ~20% of individuals with PD may develop severe dementia. Cognitive deficits often include impairments in visuospatial discrimination, frontal lobe executive function, and memory retrieval. Deficits in executive functioning, such as planning and task execution, may be early signs of cognitive decline.

Question 19

Is there a single, universally effective treatment for Parkinson’s Disease?

Answer 19

No, treatment for PD must be highly individualized as it primarily focuses on managing the symptoms rather than preventing disease progression.

Question 20

What are some nonpharmacologic interventions that can help individuals with Parkinson’s Disease?

Answer 20

• group support
• education
• daily exercise
• maintaining a well-balanced diet

Question 21

How is the choice of pharmacologic treatment for Parkinson’s Disease determined?

Answer 21

pharmacologic treatment for PD is typically based on the severity of the individual’s symptoms

Question 22

Why is levodopa considered an essential medication for Parkinson’s Disease?

Answer 22

Levodopa, a precursor of dopamine, is a critical medication for PD because it can cross the blood-brain barrier and is converted to dopamine by an enzyme called dopa decarboxylase in the brain

Question 23

What is the “on-off phenomenon” in Parkinson’s Disease, and how does it relate to levodopa treatment?

Answer 23

The “on-off phenomenon” refers to frequent, unpredictable fluctuations in motor performance experienced by individuals with PD during the day. It includes “on” periods without dyskinesia, “on” periods with dyskinesia, and “off” periods with bradykinesia. These fluctuations are often associated with the timing of drug administration, with “on” responses coinciding with peak drug levels and “off” responses occurring with low drug levels.

Question 24

What role do dopamine agonists play in the treatment of Parkinson’s Disease?

Answer 24

Dopamine agonists are medications that directly stimulate dopamine receptors in the brain

Question 25

How do anticholinergic drugs contribute to the management of Parkinson’s Disease?

Answer 25

Anticholinergic drugs are believed to restore a balance between reduced dopamine and uninhibited cholinergic neurons in the striatum. They can help reduce tremors and rigidity and improve motor function

Question 26

What surgical treatments are available for Parkinson’s Disease?

Answer 26

• thalamotomy and pallidotomy (destruction of specific brain regions using electrical stimulation or supercooled metal probes)
• Deep brain stimulation (DBS) (nondestructive and reversible surgical procedure that implants electrodes into the brain to block abnormal nerve activity to increase the duration of “on” periods)

Question 27

What are some potential side effects of anticholinergic drugs used in Parkinson’s Disease treatment?

Answer 27

• blurred vision
• dry mouth
• bowel and bladder problems
• cognitive dysfunction
• hallucinations.

Question 28

When does tremor disappear?

Answer 28

tends to disappear with movement and during sleep.