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Management Of Aging Adult > Parkinsons (2) > Flashcards

Parkinsons (2) Flashcards

1
Q

What are characteristics of idiopathic Parkinson’s?

A

Early onset <50 years old

Tremor dominant or postural imbalance and gait disorder dominant

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2
Q

What are characteristics of secondary Parkinsonism?

A

External cause (drug induced, toxins, infectious, tumor, or trauma)

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3
Q

What are characteristics of atypical Parkinsonism (parkinson plus)?

A

Progressive supranuclear palsy

Corticobasilar degeneration

Multiple system atrophy

Dementia with Lewy body

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4
Q

What are some characteristics of progressive supranuclear palsy?

A

Eye movement abnormalities (loss of downward gaze)

Broad based gait, ataxic, and arms abduct

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5
Q

What are some characteristics of corticobasilar degeneration?

A

Apraxia

Cortical sensory loss

Myoclonus

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6
Q

What are some characteristics of multiple system atrophy?

A

Autonomic dysfunction

Abnormal postures

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7
Q

What are some characteristics of dementia with Lewy body?

A

Dementia and visual hallucinations

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8
Q

How do symptoms progress in atypical parkinsonism?

A

Faster

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9
Q

What are the risk factors of Parkinson’s?

A

Age > 60

Males

Positive family history (genetics)

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10
Q

What are prodromal markers of neurodegenerative process?

A

REM sleep behavior disorder

Depression

Autonomic dysfunction

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11
Q

What % is loss before a Parkinson’s diagnosis?

A

80%

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12
Q

What are the key symptoms of Parkinson’s?

A

Rigidity

Bradykinesia

Postural instability

Tremor

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13
Q

What can levodopa treatment lead to?

A

Dyskinesia (impairment of voluntary movement)

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14
Q

What is camptocormia dystonia?

A

Thoracolumbar flexion (due to overactive rec fem)

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15
Q

What is pisa syndrome?

A

Truncal dystonia (lateral trunk flexion)

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16
Q

What is feet dystonia?

A

Flexion of toes and inversion of ankle

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17
Q

What % of Parkinson’s patients report pain?

A

95%

76% interfering with daily life

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18
Q

Where is most pain present in Parkinson’s?

A

Back

Joint

Nerve

19
Q

What are the cognitive effects of Parkinson’s?

A

Difficulty changing cognitive or motor set with change

Affects response inhibition

Impairs automaticity of movement

20
Q

What does performing cognitive tasks increase in those with Parkinson’s?

A

Fall risk

21
Q

What is a consideration when taking meds for Parkinson’s?

A

Do not take with protein (decreases absorption)

22
Q

When do you want to work with Parkinson’s patients?

A

During their ON time (after they take medication)

23
Q

What is deep brain stimulation?

A

Delivery of high frequency stimulation to basal ganglia (overrides neuronal activity in basal ganglia)

24
Q

Will people that have a good response to levodopa have a good response to deep brain stimulation?

A

Yes

25
Q

Why do patients need to wait 5 years to do deep brain stimulation?

A

DBS will make Parkinson’s plus worse

26
Q

When should DBS be considered?

A

If tremor is predominant

27
Q

What can get worse with DBS?

A

Walking and balance

Speech and swallowing

Cognition

28
Q

What improves with DBS?

A

Tremor

Rigidity

Slowness

Dyskinesias

Less on/off fluctuations

29
Q

What is the modified Hoehn and Yahr scale?

A

1- unilateral involvement only

1.5- unilateral and axial involvement

2- bilateral involvement without impairment of balance

2.5- mild bilateral disease with recovery on pull test

3- mild to moderate bilateral disease

4- severe disability (still able to walk or stand unassisted)

5- wheelchair bound

30
Q

When do you start taking medication for Parkinson’s according to modified Hoehn or Yahr scale?

A

At 2.5

31
Q

Why do PwP have more injurious falls?

A

They pull their arms in

32
Q

Why is a fall most commonly forward and onto the knees when walking in PwP?

A

Feet freezing

33
Q

What way to PwP fall when standing?

A

Backwards

34
Q

What are continuous gait disorders in Parkinson’s?

A

Reduced arm swing, step length, and gait speed

Postural deformities

Slow turns

35
Q

What are episodic gait disorders in Parkinson’s?

A

Freezing of gait

Festinuating gait

36
Q

What is freezing of gait due to?

A

Poor coupling between anticipatory postural alignment and stepping (small shuffling steps)

37
Q

Where are feet placed involuntary on festinating gait?

A

Behind COG with rapid small steps (propelled up on toes)

38
Q

Why does festinating gait result in forward falls?

A

Upper body is propelled forward

39
Q

What are the strength training recommendations for Parkinson’s patients?

A

Large extensor groups 3x a week

40
Q

What are the aerobic training recommendations for Parkinson’s patients?

A

Large amplitude movement at moderate intensity 5x a week

41
Q

What are the flexibility training recommendations for Parkinson’s patients?

A

Cervical and axial muscles 2x a week

42
Q

What are the balance training recommendations for Parkinson’s patients?

A

1-3x a week for 30 minutes

43
Q

What do Parkinson’s patients need to do as soon as possible?.

A

Exercising

44
Q

What are the benefits of exercising in Parkinson’s patients?

A

Increased availability of dopamine

Increase in protective factors

Management Of Aging Adult (24 decks)

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