Parkinsons

Question 1

What is the pathology of Parkinson’s disease

Answer 1

Not enough dopamine, imbalance between dopamine and acetylcholine

Question 2

Is Parkinson’s insidious or does it have a sudden onset?

Answer 2

Insidious, progressive, chronic

Question 3

What are the cardinal features of Parkinson’s

Answer 3

Resting tremor that can decrease with purposeful activity, muscle rigidity, Brady kinesia, postural instability

Question 4

Does the resting tremor resolved with activity

Answer 4

Yes

Question 5

Do tremors occur/start bilaterally or unilaterally

Answer 5

Starting unilaterally that spreads contralaterally over several years

Question 6

What is muscle rigidity

Answer 6

Increased resistance to passive range of motion that is a jerking quality, also started unilaterally than spreads

Question 7

What is Brady kinesia

Answer 7

Generalize slowness in movement, Can be described as a weakness, and coordination, and tiredness

Question 8

What is the major cause of disability in Parkinson’s patients? Which symptom

Answer 8

Brady kinesia

Question 9

What are some non-motor clinical manifestations of Parkinson’s that could be considered neuropsychiatric

Answer 9

Cognitive dysfunction, dementia, psychosis, hallucinations, mood disorders, or factory dysfunction, sleep disturbance,
Autonomic dysfunction including orthostasis constipation dysphasia diaphoresis urinary difficulties and sexual dysfunction.
Pain and sensory disorders including face abdomen genitals and joints.

Question 10

What will a patient with Parkinson’s gait look like

Answer 10

Short shuffling gait

Question 11

Micrographia

Answer 11

PD/OFS handwriting, writing is shrunken head tilted compared to normal handwriting

Question 12

How to diagnose Parkinson’s

Answer 12

No specific diagnostic test, based on history and clinical features. Usually 2 to 3 signs of classic triad present. Ultimate confirmation would include a positive response to anti-parkinsonian drugs

Question 13

Levodopa

Answer 13

Most effective drug for symptomatic Parkinson’s, most effective for Bradykinesia’s, lots of side effects, on and off phenomenon eventually occurs

Question 14

Main drug therapy for Parkinson’s

Answer 14

Levodopa, dopamine agonist, anti-cholinergic. Anti-cholinergic would be used as a mono therapy, dopamine would be used as a mono therapy or combo medication.

Question 15

What is the on off phenomenon?

Answer 15

Consequence of long-term levodopa. On equals mobile, off equals immobile. Eventually becomes more unpredictable

Question 16

What to do if your patient is experiencing the on off phenomenon

Answer 16

Reduce enter does intervals, controlled release medication, avoid high protein meals

Question 17

Deep brain stimulation

Answer 17

Most common surgical treatment for advance Parkinson’s, adjust to control symptoms, is reversible, electrodes surgically placed in brain and connected to neurostimulator that is a pacemaker device in the chest

Question 18

General care for a patient with Parkinson’s

Answer 18

A lot extra time for verbal responses, plenty of time for ADL and collaborate with OT, listen, administer meds properly and monitor for side effects, implement interventions to prevent complications of a mobility such as constipation contractures or skin breakdown, encourage physical exercise, collaborate with PT

Climb rate with speech pathologist due to concerns of dysphasia or hypophonia, collaborate with dietitian, assess for depression and anxiety, assessed for insomnia or sleepiness

Question 19

Dietary considerations

Answer 19

When working with a dietitian ensure that the patient has a balanced diet, high calorie, high-fiber, increase fluid intake, bite-size pieces, small frequent meals

Question 20

What to teach a patient when they are freezing while walking

Answer 20

Consciously think about stepping over imaginary a real lines on the floor Colonel drop items for them to stop over, Rockside decide, lift toes when stepping, one step backward two steps forward. Remove any rugs or tripping hazards in the home