Parkinson's Disease Flashcards

1
Q

What are features of pyramidal/ upper motor neurone disturbance?

A

pyramidal weakness and spasticity

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2
Q

What are features of parkinsonian syndrome?

A

rigidity; akinesia/bradykinesia and resting tremor

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3
Q

What is characteristic of a tremor caused by cerebellar dysfunction?

A

an intention tremor- irregular lage-amplitude, worse at the end of purposeful movements

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4
Q

What are the 2 subtypes of the motor features in PD?

A

termor dominanat and non-tremor dominant PD

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5
Q

What are the non-motor features of PD?

A

olfactory dysfunction, cognitive impairment, psychiatric symptoms, sleep disorders, autonomic dysfunction, pain and fatigue

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6
Q

What is the timeline of developing non-motor symptoms compared to motor symptoms in PD?

A

non-motor often present before the onset of classical motor features

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7
Q

What must be present for a diagnosis of PD to be made?

A

motor features

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8
Q

What is the diagnostic criteria for the diagnosis of PD?

A

bradykinesia plus muscular rigidity; rest tremor; postural instaibility

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9
Q

What are Lewy bodies?

A

insoluble and aggregated intracellular inclusions of misfolded a-synuclein

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10
Q

What is the neurohystological hallmark of PD?

A

Lewy bodies

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11
Q

What is the most common genetic cause of dominant PD?

A

LRRK2

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12
Q

What ist he most common cause of recessive PD?

A

parkin

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13
Q

what side effects are assocaited with dopamine agonists and levodopa?

A

nausea, daytime somnolence and oedmea; impulse control disorders; hallucinations

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14
Q

What is longterm use of levodopa associated with?

A

motor complocations- dyskinesia and motor fluctuations

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15
Q

What is thought to be the caues of motor fluctuations and dyskinesia with levodopa?

A

the pulsatile stimulation of striatal dopamine receptors in later disease stages

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16
Q

What can be used to manage psychosis in PD?

A

clozapine

17
Q

How can bradykinesia be assessed?

A

asking the patient to perform some repetitive movements as quickly and widely as possible

18
Q

What is a feature of tremor seen in PD in addition to at rest?

A

reemerging tremor- typically reappears after 10 seconds when arms held outstretched

19
Q

When is a resting tremor best observed?

A

while patient is focused on a particular mental task

20
Q

What is rigidity?

A

increased muscle tone felt during examination by passive movmeent

21
Q

What distinguishes rigidity from spasticitiy?

A

no increase in resisitance with higher mobilizing speed with rigidity

22
Q

What is festination?

A

very fast succession of steps and difficulties stopping

23
Q

How many patients with PD develop dementia after 20 years?

A

> 80%

24
Q

What are the features of vascular parkinsonism?

A

affects predominantly lower limbs; rest tremor is uncommon; poo levodopa response

25
Q

What are the features of drug induced parkinsonism?

A

symmetrical; coarse postural tremor

26
Q

What type of tremor is responsive to alcohol?

A

essential tremor