Parkinson's Pt 1 Flashcards
overt symptoms of parkinsons might not be seen until ___________ of dopanergic cells are lost
60
60-80%
What are prodromal symptoms
symptoms that show up prior to the classic motor symptoms
Includes loss of smell, constipation, blood pressure fluctuations, sleep disorders
What are the TRAP Symptoms of parkinsons? Classic clinical features
Tremor (resting)
Rigidity (cogwheel)
Akinesia (bradykinesia)
Postural Instability
What is often the first motor symptom to appear in parkinsons
Micrographia
What is “decreased executive function” in parkinsons
They might take longer to process information, dont keep repeating the same thing
wait 10 seconds for them to respond
Lewybody parkinson’s progression is __________
Rapid progression
What is parkinson’s disease psychosis
Pts experience hallucinations or delusions
Patients often report which symptoms of parkinsons are more distressing?
Non-motor symptoms
What is the most important Hoen Yahr stage to recognize?
Stage 3, pt will have postural instability and falls
Parkinsons patients should be refered to PT at what Hoen and Yahr stage?
Stage 1- unilateral disease
Modified Hoehn and Yahr stages
0- No sign of disease
1- Unilateral disease
1.5- Unilateral plus axial involvement
2- bilateral disease without imbalance
2.5- bilateral disease with recovery on “pull test”
3- Mild to moderate bilateral disease, some postural instability, physically independent
4- moderate/severe bilateral, frequent LOB, 50% physically independent
5- non-ambulatory 80-100% dependent
What Hoehn Yahr stage is non-ambulatory
Stage 5
What hoehn and yahr stage is the first to be bilateral
2
What is an essential tremor
NOT parkinsons
Intention tremor, gets worse w/ activity
can be seen in hands, feet, face, speech
Idiopathic parkinson’s disease has a ________ onset
Characterized by a __________ tremor
Unilateral
Resting
Idiopathic parkinson’s disease is characterized by a ___________ base of support and posture
reduced _____________
and a ______________ effect of levodopa medication
narrow based gait with flexed/stooped posture
Reduced arm swing with tremor
Sustained and significant levodopa effect
Non-Idiopathic parkinsons, other parkinsonian syndromes:
______ at onset
_________ progression
symmetry at onset
Rapid progression- H&Y stage 3 in 3 years
Non-Idiopathic parkinsons, other parkinsonian syndromes:
_____ tremor
_____ at early presentation
lack of tremor
Falls at presentation and early in disease course
Non-Idiopathic parkinsons, other parkinsonian syndromes:
early _____________
______ to levadopa
Early dysautonomia
Poor response to levadopa
What is included in the FIGS acronym
What does Progressive Supranuclear Palsy (PSP) have that idiopathic parkinsons does not:
Frequent and early falls BACKWARDS
Ineffective medication
Gaze stabillity problems
Speech and swallowing changes
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