Parkinsons and huntingtons

Question 1

with insufficient dopamine, which pathway is dominant?

Answer 1

“no go pathway”

hypokinesia

Question 2

Movement symptoms of Parkinson’s

Answer 2

Bradykinesia
Tremor
Rigidity
Postural instability
Drooling
Micrographia
Festination
Freezing
Soft speech
Masked face

Question 3

Non-movement symptoms of Parkinson’s

Answer 3

apathy
Anxiety
Breathing difficulty
Anosmia
Constipation and nausea
Cognitive changes
Depression
Fatigue
Hallucinations
Pain
Sleep disorders
Bone health

Question 4

prognosis of Parkinson’s

Answer 4

Shift from unilateral to bilateral involvement
Increasing rigidity and postural flexion
Increasingly limited mobility and increasing need for assistance
Eventually, wheelchair and or bedbound
Cause of death, usually pneumonia

no cure

Question 5

stage 1 and 1.5 of Parkinson’s

Answer 5

1- unilateral movement only
1.5- unilateral and axial involvement

Question 6

stage 2, 2.5, 3 Parkinson’s disease staging

Answer 6

2- bilateral involvement without impairment of balance
2.5- mild bilateral disease with recovery on pull test
3- mild to moderate bilateral disease, some postural instability, physically independent

Question 7

stage 4, 5 Parkinson’s disease staging

Answer 7

4- severe disability, still able to walk or stand unassisted
5- wheelchair bound or bedridden, unless aided

Question 8

problem with the modified hoehn and yahr staging

Answer 8

It only takes into account the motor aspect of the symptoms of Parkinson’s

based on mobility, not the mental or behavioral symptoms, not ADLs
not based on dominant or nondominant side

Question 9

unified Parkinson’s disease rating scale

Answer 9

Meditation behavior and mood
Activities of daily living
Motor
Modified hoen and yahr scale
schwab and england adl scale

Score of zero equals no disability
max 199 points

Question 10

Huntingtons disease

Answer 10

degeneration of caudate nucleus
decreases output signals from the basal ganglia leads to disinhibition
then there is Excessive output from the motor cortex
Hyperkinesia

Question 11

Psychiatric effects of Huntington’s disease

Answer 11

depression, irritability, anxiety, apathy
Aggressive, outburst, impulsivity, social withdrawal, suicidal ideation
Depressive symptoms associated with the rapid declining functional abilities

Question 12

cognitive impairments of Huntington’s disease

Answer 12

Slowed thinking, impaired ability to manipulate information, poor attention, impaired memory

Difficulty switching from one task to the other

can lead to difficulty with ADLs

Question 13

sensorimotor involuntary deficits of Huntington’s

Answer 13

chorea

dystonia (up to 95%) muscle spasms
-Prevalent; shoulder internal rotation, fist clenching, excessive knee flexion, foot inversion
-increase with disease, severity, and associated decline in functional capacity

Question 14

sensorimotor voluntary movements deficits HD

Answer 14

Slow and hypometric saccadic eye movements

dysphasia and dysarthria

Slow and uncoordinated arm and hand movements

Abnormal control of posture, balance, and gait

Highly correlated with disease severity, and functional disability

Question 15

What do you want to assess with Huntington’s disease?

Answer 15

balance
Mobility

Question 16

berg balance scale BBS

Answer 16

higher score the better

Increase risk of falls if the score is less than equal to 40/56

Question 17

timed up and go TUG

Answer 17

Stand up walk 10 feet turn around and come back and sit down
Increased the risk of falls if the score is greater than equal to 14 seconds

Question 18

activities specific balance confidence scale, ABC scale

Answer 18

patient reported scale
confidence with keeping balance
100% Is best score
Less than 50% with recurrent fallers

Question 19

tinettis mobility test

Answer 19

correlated with UHRS
1.8 more likely to fall if the score is less than equal to 21/28