Parkinson's Pathology Flashcards
Parkinson’s disease (PD) clinical course is…
Chronic, progressive, and neurodegenerative
PD is caused by…
Progressive death of dopamine-producing neurons
Dopamine neuron loss is primarily in the ____
Brain?
Substantia nigra
Dopamine is important for ____ movements.
Smooth, coordinated, and controlled movements
Death of dopaminergic neurons means that the messages telling the body how + when to move…
Messages are delievered slowly/incompletely - patient cannot initiate and control movements in a normal way
Etiology of PD is…
Unknown - some decline of dopaminergic neurons occurs with aging, acceleration of this process = PD
Risk factors for PD include…
Family hx = genetic component
Pesticide exposure
Repeated head injury
Protective factors for PD include…
Cigarette smoking
High coffee consumption
Intensive exercise
Hallmark movement symptoms of PD include…
T-R-A-P
Tremor
Rigidity
Akinesia/bradykinesia
Postural instability
Slow, stiff, shaky
PD is diagnosed…
Clinically (no lab test/scan) - is also a heterogenous disorder with substantial variations in clinical presentation
Movement disorder society states that PD clinical diagnostic criteria must present with…
Bradykinesia, and either rest tremor or rigidity
Movement disorder society states that PD clinical diagnostic criteria has supportive criteria, such as…
Clear response to dopaminergic treatment
Levodopa-induced dyskinesias
Olfactory loss (possibly prodromal)
Two distinguished subtypes of PD include…
Tremor
Akinetic/rigid
Tremor subtype PD presents…
More often in younger PD patients
Typically have a slower, more benign course of progression
Akinetic/rigid subtype PD presents…
More often in older patients, more likely to develop dementia
Have a more rapid rate of progression of motor symptoms
There are other forms of Parkinsonism that may have similar features to PD, but different etiology. The key feature to distinguish this is…
They will not respond to Levodopa
Dopamine treatment should help improve the signs of idiopathic PD
Medications that may cause Parkinsonism are primarily…
Dopamine blockers (AP’s, metoclopramide)
Prodromal PD symptoms may include…
Hyposmia
Constipation
Depression
Fatigue
REM sleep behaviour disorder
REM sleep behaviour disorder is…
Loss of muscle paralysis during REM sleep
Acting out their dreams
Early on in PD disease course, non-motor symptoms may include…
Flat affect
Micrographia
Hypophonia
Dry eyes
Later on in PD disease course, non-motor symptoms may include…
Delusions/hallucinations
Sialorrhea
Sexual dysfunction
Autonomic dysfunction
Cognitive impairment + dementia
PD treatment is used only for ____. It cannot be used for…
Symptomatic treatment - cannot modify disease progression
