Parkinson’s Disease

Question 1

What is Parkinson’s?

Answer 1

There is progressive reduction in dopamine in the basal ganglia => disorder of movement

Question 2

What is the typical presentation?

Answer 2

Asymmetrical
Old man, around 70
Gradual onset symptoms

Question 3

What is the classic triad in Parkinson’s?

Answer 3

Resting tremor
Rigidity
Bradykinesia

Question 4

What are other features of Parkinson’s?

Answer 4

Depression
Sleep disturbance and insomnia
Loss of the sense of smell (anosmia)
Postural instability (increasing the risk of falls)
Cognitive impairment and memory problems

Question 5

What dementia is associated with Parkinsonism features?

Answer 5

Dementia with levy bodies

Question 6

How is Parkinson’s diagnosed?

Answer 6

Clinically based on history and examination findings

Question 7

What are treatemnt options?

Answer 7

Levodopa (combined with peripheral decarboxylase inhibitors)
COMT inhibitors
Dopamine agonists
Monoamine oxidase-B inhibitors

Question 8

What is levodopa?

Answer 8

Synthetic dopamine

Question 9

What is the main side effects of levodopa?

Answer 9

Dyskinesia

Question 10

What can manage the dyskinesia associated with levodopa?

Answer 10

Amatadine a glutamate antagonist

Question 12

What do dopamine agonists do?

Answer 12

Mimic the action of dopamine in the basal ganglia

Question 13

When are dopamine agonists used?

Answer 13

Used to delay the use of levodopa

Question 14

What is a side effect of dopamine agonists?

Answer 14

Pulmonary fibrosis

Question 15

What are examples of dopamine agonists?

Answer 15

Bromocriptine
Pergolide
Cabergoline