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Neurology (Calum) > Parkinson's Disease > Flashcards

Parkinson's Disease Flashcards

1
Q

What is the triad of parkinsonism?

A

rigidity
bradykinesia
resting tremor

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2
Q

What is ballismus?

A

increased amplitude chorea

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3
Q

What is chorea?

A

fragments of movements flow irregularly from one body segment to another causing a dance-like appearance

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4
Q

What structures make up the basal ganglia?

A 
caudate nucleus 
putamen 
globus pallidus 
sub thalamic nucleus 
substantia nigra
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5
Q

What are the 2 broad subtypes of Parkinson’s?

A

Tremor dominant

non-tremor dominant

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6
Q

Which subtype of parkinsons has a better prognosis?

A

tremor-dominant

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7
Q

Which symptoms tend to come first, motor or non-motor?

A

non-motor

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8
Q

What are some examples of non-motor features?

A 
olfactory dysfunction 
cognitive impairment 
psychiatric symptoms 
sleep disorders 
autonomic dysfunction 
pain and fatigue
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9
Q

How is rapid eye movement sleep behaviour disorder treated?

A

clonazepam/melatonin at bedtime

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10
Q

What is the pathological hallmark of parkinson’s disease?

A

loss of dopaminergic neurones in the substantia nigra

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11
Q

What protein forms Lewy Bodies?

A

alpha-synuclein

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12
Q

what is the greatest risk factor for PD?

A

Age

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13
Q

Is there a genetic component to PD?

A

Yes

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14
Q

Which drug cures parkinsons disease?

A

No cure!!

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15
Q

Which drugs can be effective in treating tremor?

A

anticholinergic agents
trihexyphenidyl
clozapine

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16
Q

What adverse effect are associated with dopamine agonists and levadopa?

A

nausea
daytime somnolence
oedema
psychosis

17
Q

What is an example of a dopamine agonist?

A

bromocriptine

18
Q

What is the difference between dopamine agonists and levadopa?

A

levodopa is converted into dopamine in the brain, dopamine agonists mimic the effect of dopamine without needing to be converted

19
Q

Which patients should not receive dopamine agonists?

A

gamblers, binge eating, compulsive spenders

elderly with cognitive impairment

addition/OCD

20
Q

At what point during treatment do dyskinesias tend to occur?

A

maximum dose of levodopa

21
Q

Can dopaminergic therapies cause psychosis?

A

yes - drug induced psychosis

22
Q

What drugs are used to manage PD psychosis?

A

clozapine

quetiapine

23
Q

What is rivastigmine?

A

cholinesterase inhibitor

helps reduce visual hallucinations and delusions in PD patients

24
Q

what surgical treatments are available for PD?

A

deep brain stimulation of the sub thalamic nucleus or globus pallidus internus

25
Q

What is bradykinesia?

A

slowness of movement with progressive loss of amplitude/speed

26
Q

What movements assess bradykinesia?

A

opening and closing hand

foot tapping

27
Q

What other motor symptoms are seen in PD?

A

hypomimia
hypophonia
micrographia

28
Q

What kind of tremor is seen in PD?

A

resting tremor

commonly “pill-rolling”

29
Q

What features are seen in Parkinsonian gate?

A 
stooped posture 
slow, shuffling 
decreased arm swing 
slow turning with many steps 
freezing 
festination
30
Q

What are common premotor symptoms?

A

sleep disorder
loss of smell
constipation

31
Q

Parkinson’s disease is typically symmetrical - T/F?

A

False

32
Q

What is a DAT scan?

A

dopamine transporter imaging to assess dopaminergic function

33
Q

What will be seen on a DAT scan in a patient with essential tremor?

A

nothing

34
Q

What is drug induced parkinsonism?

A

emergence of parkinsonism after specific drug treatment

35
Q

What are distinguishing features of essential tremor?

A

autosomal dominant inheritance

responsive to alcohol

36
Q

what features are seen in multi-system atrophy?

A

dysautonomia
cerebellar features
parkinsonism

37
Q

What is progressive supra nuclear palsy?

A

symmetrical akinetic rigid syndrome with predominantly axial involvement

38
Q

which facial muscle is continuously activated in patients with PSP?

A

frontalis

Neurology (Calum) (21 decks)

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