Parkinsons

Question 1

What is Parkinson’s characterised by anatomically

Answer 1

Dopaminergic neuron loss in the substantial migration pars compactanwith alpha synuclein containing levy bodies

Question 2

Motor symptoms

Answer 2

Tremor- worse at rest, pill rolling
Rigidity/ increased tone- cogwheel rigidity
Bradykinesia/hypokinesia- slow to initiate movement and low amplitude

Question 3

Non motor symptoms

Answer 3

olfactory disfunction, cognitive impairment, psych symptoms, sleep disorders, autonomic dysfunction, pain and fatigue, smell changes, urinary dysfunction, constipation

Question 4

Which comes first- motor or non motor symptoms

Answer 4

Non motor symptoms can precede motor symptoms by up to a decade

Question 5

Presentation

Answer 5

Bradykinesia plus 1/ more of:
tremor at rest
postural instability +/- ,muscular rigidity
Non motor symtoms

Question 6

Pathology

Answer 6

mitochondrial DNA dysfunction causes degradation of dopaminergic neutrons in substantial migration
Sections through brainstem- loss of black pigment in substantial nigraand locus coeruleus.

Question 7

Progression

Answer 7

Worsening of motor symptoms

Late stage0 treatment resistant

Question 8

Neurohistological hallmark

Answer 8

Lewy bodies

Question 9

Risk factors

Answer 9

Age
Male
Genetics- GBA mutation, LRRK2, SNCA

Question 10

Treatment

Answer 10

Levodopa
Dopamine agonists
Monoamine oxydase type B inhibitors

Question 11

Side effects of dopamine agonists

Answer 11

Nausea, daytime solomence, oedema
Impulsive disorders eg gambling
Hallucinations

Question 12

Long term use of levodopa

Answer 12

Associated with dyskinesia and motor fluctuations