Parkinson's Disease Flashcards
The diagnosis of PD is entirely based on ______ and ______.
History
Physical Examination
List 4 signs and symptoms associated with PD.
- Resting tremor
- Bradykinesia/Akinesia
- Rigidity
- Festinating gait handwriting or speech
PD is caused by the degeneration of the ________.
Substantia nigra
A diagnosis of PD is further confirmed by a patient’s positive response to ________.
Dopamanergics
Patient experiences a decrease in symptoms when placed on drugs, such as L Dopa, further confirming the diagnosis of PD.
What are 2 differential diagnoses that are characterized by a poor response to Levodopa?
- Multiple Systems Atrophy
2. Progressive Supranuclear Palsy
Multiple systems atrophy results in ________ abnormalities such as ______ and _______.
ANS abnormalities
Hypotension
Tachycardia
Multiple Systems Atrophy is caused by the accumulation of the protein ______ in the ______ cells.
Accumulation of the protein ALPHA SYNUCLEIN in the GLIAL cells
List 4 symptoms of progressive supranuclear palsy.
- Rigidity
- Bradykinesia
- Oculomotor impairments
- Depression
Progressive supranuclear Palsy is caused by _____ protein accumulation in the ______.
Tau protein accumulation
Brain stem
_______ and ________ are 2 common types of tremors seen in patients with PD.
Resting tremor (affecting hands and feet)
Pill rolling tremor (affecting the fingers)
What is bradykinesia? (2)
- Slowness of movement
2. Reduction in movement amplitude
What is rigidity? What type of rigidity is commonly seen in patients with PD?
- Increase in muscle tone that causes resistance to passive movement
- Cog wheeling type
Describe the postural instability often seen in patients with PD.
Stooped forward posture with decreased postural control
List 7 CONTINUOUS gait disorders seen in patients with PD.
- Reduce speed
- Reduce stride length
- Decrease arm swing
- Decrease single support
- Increase double support
- Increase cadence
- Gait shuffling
List 2 EPISODIC gait disorders common in patients with PD.
- Freezing of gait: gait is halted and the patient complains that his/her feet are glued to the ground.
- Festinating gait: short, jerky steps, COM in front of BOS
What is the most common neuropsychiatric disorder affecting patients with PD?
Cognitive decline
List 5 neuropsychiatric disorders commonly affecting patients with PD.
- Cognitive decline (84%)
- Dementia (48%)
- Daytime sleepiness (79%)
- Depression (50%)
- Hallucinations (21%)
81% of patients with PD report experiencing _____.
FALLS
List 4 additional signs and symptoms associated with PD.
- Tented hands
- Micrographia
- Masked face
- Paucity of speech
______ agents are used to medically manage PD. What are the effects of the agents in the first few years vs after several years of use?
Dopaminergic agents
First several years = sxs improved with limited side effects
After several years = on and off state; dyskinesias
Describe one surgical treatment used to treat PD.
Deep brain stimulation
Implantation of electrodes inside the sub-thalamus connected to pacemakers implanted under the skin
List 2 types of destructive surgeries used to treat PD.
Palliodotomy: Thermocoagulation at the globus pallidus
Thalamotomy
List 2 rating scales used for the evaluation of motor impairments and disability in patients with PD.
- Hoehn and Yahr Staging
2. Unified Parkinson’s Disease Rating Scale (UPDRS)
List the 7 stages that make up the Hoehn and Yahr Scale.
- Unilateral involvement only
1.5 Unilateral and axial involvement
2 Bilateral involvement without impairment of balance
2.5 Mild Bilateral Disease with recovery on pull test
3 Mild to moderate bilateral disease; some posture instability; physical independent
4 Severe disability; still able to walk or stand unassisted
5 W/C bound or bedridden unless aided
