Parkinson's Disease

Question 1

What is PD?

Answer 1

Chronic, progressive neurodegenerative condition resulting from the loss of dopamine-containing cells of the substantia nigra of the basal ganglia

Question 2

What is the usual age of onset?

Answer 2

Around 60

Question 3

What gene may be mutated?

Answer 3

PINK1

Question 4

What is Parkinsonism?

Triad

Answer 4

1. Resting tremor (pill-rolling)
2. Bradykinesia & difficulty initiating movement
3. Rigidity (cog-wheeling)`

Question 5

Facial signs

Answer 5

Reduced expression, reduced blinking

Question 6

Gait?

Answer 6

Slow, shuffling gait

Question 7

What is lead pipe rigidity?

Answer 7

Constant resistance felt when limb is passively flexed

Question 8

Speech?

Answer 8

Slow & monotonous

Question 9

How is PD diagnosed?

Answer 9

Examination & clinical presentation

Question 10

When should someone be referred?

Answer 10

Before starting treatment

Question 11

What drugs may be causing PD symptoms?

Answer 11

Anti-psychotics

Question 12

Website to recommend to patients

Answer 12

parkinsons.org

Question 13

What is first line for PD?

Answer 13

Levodopa

Question 14

How does Levodopa work?

Answer 14

Dopamine precursor

Question 15

Side effects of levodopa

Answer 15

Dyskinesia, nausea

Question 16

Give 3 treatments of PD

Answer 16

Levodopa
Monoamine oxidase inhibitors
Oral dopamine agonists

Question 17

What type of drug is ropinirole?

Answer 17

Oral dopamine agonist

Question 18

Side effects of ripinirole

Answer 18

Hallucinations & impulsive behaviour

Question 19

What anti-emetic would you not give someone with PD?

Answer 19

Metaclopramide - can worsen symptoms of PD

Question 20

What drugs interact with monoamine oxidase inhibitors?

Answer 20

Anti-depressants