Parkinsons disease Flashcards

1
Q

Parkinson’s disease pneumonic

A
T - tremor 
R - rigidity 
A - akinesia 
P - postural instability 
P - postural hypotension 
S - sleep disorders 

P - psychosis
D - depression / dementia

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2
Q

hallmark of PD

A

dopaminergic neuron loss in substantia nigra pars compacta

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3
Q

Classic tremor in PD

A

pill rolling tremor

tremor @ rest - vanishes with movement

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4
Q

is head tremor typical in PD?

A

no

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5
Q

Rigidity + rest tremor = ?

A

cog-wheel rigidity

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6
Q

PD - narrow or wide based gait?

A

narrow

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7
Q

greatest genetic RF in PD

A

GBA mutation

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8
Q

tobacco smoking, NSAIDs, CCB use, alcohol &raquo_space; increased or decreased risk of PD?

A

decreased

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9
Q

Treatment of PD

A

young + fit @ onset

  1. Da agonists - ropinorole, pramipexole
  2. MOABI - rasagiline, selegiline
  3. L-DOPA

frail

  1. L-DOPA
  2. MOABI
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10
Q

PD + dementia > Rx =?

A

Rivastigmine

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11
Q

drug class good for tremor in PD

A

anticholinergics

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12
Q

1st line for psychosis in PD

A

clozapine

antipsychotics can worsen PD!

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13
Q

S/E of both dopamine agonists and levodopa

A

daytime somnolence and oedema

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14
Q

Levodopa - end of dose effect tx?

A

COMT inhibitor

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15
Q

when should dopamine agonists be avoided?

A

history of addiction, OCD

elderly due to hallucinations s/e

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16
Q

what class of drugs is most associated with drug induced parkinsonism

A

antipsychotics

17
Q

which part of the body does vascular parkinsonism predominantly affect

A

lower limbs

18
Q

rest tremor in vascular parkinsonism

19
Q

progressive supranuclear palsy

A

presents similarly to parkinsons with gait and balance impairment
rarely see tremor
inability to make vertical saccades
NO response to levodopa

20
Q

presentation of Fragile X tremor ataxia syndrome

A

late onset (>50)
postural/intention tremor
decreased frontal cognition
peripheral neuropathy

21
Q
  • triad of multi system atrophy

- MRI feature?

A

dysautonomia
cerebellar features
parkinsonism

MRI: hot cross bun sign