Parkinson's Disease Flashcards
Your patient Mr. P. D., age 60, has a recent diagnosis of Parkinson disease. He presents with multiple questions about his diagnosis and possible treatment options.
Several non-motor symptoms preceded Mr. P. D.’s motor symptoms of Parkinson disease. List three of the non-motor symptoms that are found to precede the diagnosis.
Constipation
Rapid eye movement (REM) sleep disorder
Depression
Olfaction impairment
CFPC: Self-Learning Vol 32.4 (August 2017)
Your patient Mr. P. D., age 60, has a recent diagnosis of Parkinson disease. He presents with multiple questions about his diagnosis and possible treatment options.
Mr. P.D. sometimes has difficulty getting to the pharmacy on time to renew his prescriptions. List two conditions that can occur when antiparkinsonian medications are withdrawn abruptly.
Acute akinesia
Neuroleptic malignant syndrome
Your patient Mr. P. D., age 60, has a recent diagnosis of Parkinson disease. He presents with multiple questions about his diagnosis and possible treatment options.
Mr. P. D. returns after five years of treatment and notes that motor fluctuations and dyskinesias are worsening despite treatment with levodopa-carbidopa. List three medications that could be offered to reduce “off” time.
Catechol-0-methyltransferase (COMT) inhibitors(e.g., entacapone)
Monoamine oxidase B inhibitors (e.g., rasagiline or selegiline)
Dopamine agonists (e.g., pramipexole, ropinirole, rotigotine patch, bromocriptine).
What are the motor symptoms of Parkinson’s disease? List 4.
Motor manifestations of the disorder begin asymmetrically, and commonly include:
Resting tremor A soft voice (hypophonia) Masked facies (initially presenting as reduced blink rate), Small handwriting (micrographia) Stiffness (rigidity) Slowness of movements (bradykinesia) Shuffling steps Difficulties with balance.
Rizek P, Kumar N, Jog MS.An update on the diagnosis and treatment of Parkinson disease.. CMAJ.2016;188:1157-1165
