Parkinson's disease Flashcards

1
Q

What is Parkinson’s disease?

A

A movement disorder characterised by: tremor at rest, rigidity, bradykinesia (Slowness of movement and increasing slowness of movement over constant movement)

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2
Q

Describe the aetiology of Parkinson’s disease

A

1% of people over 65 are affected
Median age of onset is 60 years old

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3
Q

What are some risk factors for Parkinson’s disease?

A
  • Increasing age
  • Positive family history
  • Male gender
  • Environmental factors
  • Genetic factors
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4
Q

What are some environmental factors that increase risk of Parkinson’s disease?

A

Pesticide exposure
Prior head injury
Rural living
ß-Blocker use
Well-water drinking

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5
Q

What are some factors that may decrease risk of Parkinson’s disease?

A

Tobacco smoking
Coffee drinking
NSAID use
Ca2+ channel blocker use
Alcohol consumption

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6
Q

Describe the pathology of Parkinson’s disease?

A

Parkinson’s disease is caused by loss of domaminergic (Inhibitory) cells in the substantia nigra and locus coeruleus

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7
Q

What are the main sub-types of motor symptoms in Parkinson’s disease?

A

Tremor dominant
Non-tremor dominant
Mixed

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8
Q

What are some motor symptoms of Parkinson’s disease?

A

Bradykinesia
Resting tremor
Rigidity
Postural and gait impairment

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9
Q

What is bradykinesia?

A

Slowness of movement with progressive loss of amplitude or speed during attempted rapid alternating movement of body segments

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10
Q

What is a resting tremor?

A

Rhythmic oscillatory involuntary movement of affected body part at rest

Often described aspill-rollingbecause the patient appears to be rolling something between thumb and forefinger

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11
Q

What is rigidity?

A

Stiffness on passive limb movement is described as ‘lead pipe’, as it is present throughout the range of movement and, unlike spasticity, is not dependent on speed of movement

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12
Q

What are some signs of postural and gait impairment in Parkinson’s disease?

A
  • Stooped posture owing to impaired postural reflexes (major contributor to falls risk)
  • Gait gradually becomes shuffling
  • Reduced arm swing during movement
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13
Q

What are some non-motor symptoms of Parkinson’s disease?

A
  • Sleep disorders
  • Hallucinations
  • GI dysfunction
  • Depression
  • Cognitive impairment/dementia
  • Anosmia (Loss of smell) - May be a prodrome of Parkinson’s disease
  • Issues with speech and swallowing
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14
Q

What are some issues in speech and swallowing that can occur in Parkinson’s disease?

A
  • Speech becomes quiet, indistinct and flat
  • Drooling
  • Swallowing difficulty is a late feature that may eventually lead to aspiration pneumonia as a terminal event
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15
Q

How is a diagnosis of Parkinson’s disease made?

A
  • Parkinsonism
  • No alternative explanation
  • Responds to dopamine
  • No tests usually required (DaTSCAN may be used)
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16
Q

How is DaTSCAN used in Parkinson’s disease?

A

May show some changes, however, these are not specific to Parkinson’s

17
Q

What are some pharmacological management options for motor symptoms in Parkinson’s disease?

A

Dopamine replacement therapy

18
Q

What are some drugs used as dopamine replacement therapy in Parkinson’s disease?

A

Levodopa
Dopamine agonists
Monoamine oxydase type B inhibitors

19
Q

What are some possible management options for tremor in PD?

A

Anticholinergic agents
Trihexyphenidyl
Clozapine

20
Q

What are some pharmacological management options for non-motor symptoms of PD?

A

SSRIs for depression
Osmotic laxatives for constipation
Amantadine for dyskinesia

21
Q
A