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Neurology SOH > Parkinsons Disease > Flashcards

Parkinsons Disease Flashcards

1
Q

Which type of movement disorder is it?

A

Hypokinetic

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2
Q

Definition

A

Motor and non motor difficulties arising from brain dysfunction through the reduced production of dopamine

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3
Q

There is increased/decreased production of dopamine

A

Decreased

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4
Q

It affects a specific part of the brain. True or false?

A

False

- it affects the whole brain

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5
Q

Are there any diagnostic tests available at an early/prodromal state?

A

No

- b the time motor features are detected, the disease is well advanced

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6
Q

Pathogenesis

A

Degeneration of substantia nigra

Substantial loss of dopaminergic neurones in the substantial nigra pars compacta

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7
Q

What would a cross section through the brain stem show

A

Loss of normally black pigment in the substantial nigra

Locus coeruleus

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8
Q

Pigment loss in the substantial nigra correlates with ?

A

Loss of domaminergic cells

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9
Q

What pathological feature may remaining neurones show?

A

Lewy bodies

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10
Q

What are lewy bodies?

A

Eosinophilic alpha-syunclein containingg inclusion granules

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11
Q

What do lewy bodies look like?

A

Dense core with a surrounding halo

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12
Q

Cause

A

Unknown

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13
Q

More common in males/females

A

Males

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14
Q

More common in younger/older population?

A

Older population

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15
Q

What is parkinsonism

A

Symptoms that are compatible with parkinson disease but the underlying cause may be different

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16
Q

Which symptoms tend to arise first - motor symptoms or non motor symptoms?

A

Non-motor symptoms

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17
Q

Non motor features

A 
Sleep disorders 
Hallucinations
Constipation
Fatigue 
Depression
Cognitive impairment 
Anosmia
Pain
Bladder problems 
Loss of facial expression (hypomimia)
Soft speech (hypophonia)
18
Q

Motor features

A 
Resting tremor 
Rigidity
Bradykinesia
Gait abnormalities 
Postural instability
19
Q

Motor features - resting tremor

A

When patient is relaxed and sits down there is a pill rolling tremor
- opposing circular movements of the thumb and index finger

20
Q

Motor features - the resting tremor is symmetrical. True or false?

A

False

- asymmetrical

21
Q

Motor features - the resting tremor vanishes with active movement. True or false?

A

True

22
Q

Motor features - rigidity. There is increased/decreased muscle tone?

A

Increased

23
Q

Motor features - movements are stiff. True or false?

A

True

24
Q

Motor features - bradykinesia

A

Slowness of movements

Difficulty initiating movements

25
Q

How can you assess bradykinesia?

A

Ask the patient to perform some repetitive movements as quickly as possible

26
Q

Motor features - gait abnormalities

A 
Shuffling gait 
short stepped gait 
slow gait 
absence of swinging arms whilst walking 
slow turning with multiple steps
27
Q

Motor features - postural instability

A

Pull the patient back slightly and they fall backwards

28
Q

Cerebellar signs should be present/absent?

A

Absent

29
Q

Diagnostic tests are required to confirm the diagnosis. True or false?

A

False

- clinical diagnostic test and diagnostic tests are not usually required

30
Q

Confirmation of diagnosis

A 
Parkinsonism 
- bradykinesia
- resting tremor
- rigidity 
- gait abnormality 
No alternative explanation for presentation 
Dopamine responsiveness
31
Q

When should treatment be initiated?

A

When symptoms cause disability or discomfort

32
Q

Management

A

Drugs that increase dopamine concentration or directly stimulate dopamine receptors

  • levodopa
  • dopamine agonists
  • monoamine oxidase type B inhibitors
33
Q

Side effects of dopamine stimulating drugs

A

Nausea
Daytime somnolence
Impulse control disorders (pathological gambling)
Drug induced psychosis

34
Q

Levodopa crosses the BBB. True or false?

A

True

35
Q

What is levodopa converted to in the brain?

A

Dopamine

36
Q

Name 3 examples of dopamine agonists

A

Pramipexole
Ropinirole
Bromocriptine

37
Q

Individuals with parkinsons disease have a decreased life span. True or false?

A

True

38
Q

Vascular parkinsonism predominantly affects which part of the body?

A

Lower limbs

39
Q

How does drug induced parkinsonism arise?

A

Caused by any drug that blocks the action of dopamine

40
Q 
Which 2 of the following medications should be avoided in patients with Parkinson’s disease?
Domperidone
Quetiapine
Haloperidol
Metochlopramide
A

Haloperidol

Metochlopramide

Neurology SOH (31 decks)

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