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Pharm > Parkinsons - Exam 4 > Flashcards

Parkinsons - Exam 4 Flashcards

1
Q

tremor means

A

rhythmic movement around a joint

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2
Q

what is the hallmark of parkinsonism

A

tremor at rest

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3
Q

movement that is involuntary can also be seen with

A

brain lesion and alc/drug toxicity

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4
Q

chorea is what

A

muscle jerks in various areas

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5
Q

chorea means ___ movement and coordination

A

impaired

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6
Q

Ballismus means

A

violent abn movements

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7
Q

athetosis means

A

slow, writhing

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8
Q

dystonia means

A

abn posture

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9
Q

tics means

A

single repetitive movements on the face especially

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10
Q

choreathetosis is caused by (7)

A

trauma, chorea gravidarum, tumors, cerebral palsy, huntingtons, ataxia telangectasia, kernicterus

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11
Q

choreoathetosis is a combination of what

A

chorea, athetosis and dystonia

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12
Q

neuronal communication is controlled by what 3 things in the brain

A

motor cortex, thalaus, basal ganglia

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13
Q

basal ganglia does what

A

regulates motor activities

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14
Q

thalamus does what

A

relays signals to cortex

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15
Q

basal ganglia is made of what

A

striatum, substantium nigra, globus pallidus, subthalamic nucleus

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16
Q

movement disorders are related to _____ dysfunction

A

basal ganglia

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17
Q

parkinson treatment targets what specific part of the basal ganglia

A

substantia nigra

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18
Q

parkinsonism is acute or progressive

A

progressive

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19
Q

symptoms with parkinsonism

A

rigidity, bradykinesia, tremor, postural instability, cognitive decline

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20
Q

anogram for parkinsons

A

TRAP, tremor, rigidity, akinesia, posture

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21
Q

____ neuron degradation is associated with the pathogenesis of parkinsonism

A

dopaminergic

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22
Q

what pathway with dopamine is specifically affected

A

nigro-striatal pathway

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23
Q

increase or decreased dopamine levels

A

decreased

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24
Q

what may lower the risk of PD

A

cigs, coffee, anti-inflammatories, uric acid

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25
Q

what is harmful/ increased risk of PD

A

lead, manganese exposure, vit. d deficiency

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26
Q

genetic factors included in PD

A

a-synuclein

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27
Q

where is a-synuclein found

A

in CNS neurons

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28
Q

where specifically are a-synucleins found in neurons

A

nucleus, presynaptic terminal, mitochondria

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29
Q

where else is a-synuclein found

A

lewy bodies

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30
Q

misfolding of proteins associated with what neurodegenerative diseases, which one specific to a-synuclein

A

parkinsons, alzheimers, multiple system atrophy, prion disease

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31
Q

Prion diseases are though to cause what

A

protein misfolding, dementia

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32
Q

risk factors with PD

A

60 or older, men, teachers, healthcare, farmers, herbicides, genetics

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33
Q

treatment for parkinsons

A

PT, levodopa, CNS antimuscarinics

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34
Q

what treat to avoid with PD

A

dopamine receptor antagonists, MPTP

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35
Q

what does MPTP do

A

destroys dopaminergic neurons

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36
Q

dopamine does not cross ___

A

BBB

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37
Q

levodopa is the __ isomer of dopa and crosses the ___ poorly and increased BBB crossing with ____

A

L isomer, BBB, carbidopa

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38
Q

effectiveness of levodopa over time

A

decreases with further neuronal loss

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39
Q

adverse effects with levodopa (6)

A

anorexia, N/V, tachy, afib, depression/anxiety, dyskinesias

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40
Q

what phenomenon with levodopa with long term use

A

on-off phenomenon, increased motility with periods of marked akinesia

41
Q

drug interactions with levodopa

A

vitamin B6 and MAOIs

42
Q

when to not take levodopa

A

psychosis, glaucoma, melanoma

43
Q

What drug to treat depression, anxiety, hallucination associated with parkinsons

A

pimavanserin

44
Q

receptor agonists of dopamine

A

pramipexole

45
Q

are dopamine receptor agonists more or less effective than levodopa and how do the side effects compare

A

less effective, less side effects but same type

46
Q

MAO-A works on what neurotransmitters

A

NE, 5-HT, dopa

47
Q

MAO-B works on what neurotransmitter

A

dopamine

48
Q

MAO-B selective MAOIs

A

selegiline

49
Q

is rasagiline an adjunct

A

yes

50
Q

catechols inactivated by what

A

COMT

51
Q

COMT inhibitors

A

tolcapone

52
Q

apomorphine is what kind of agonist

A

dopamine

53
Q

what does apomorphine relieve

A

akinesia

54
Q

surgical treatment with advanced disease of PD

A

ablation and deep brain stimulation on basal ganglia

55
Q

stem cell therapy includes ___ of fetal substantia nigra

A

implantation

56
Q

restless leg syndrome is what

A

creeping discomfort in legs,urge to move, sleep disorder

57
Q

treatment of restless leg syndrome

A

dopamine agonists, GABA, benzos, clonazepam

58
Q

treatment of alzheimers

A

prevention and palliative treatment

59
Q

acetylcholinesterase inhibitors for alzheimers

A

tacrine, rivastigmine

60
Q

NMDAr antagonist for alzheimers

A

memantine

61
Q

alzheimers can be ___ and has an ___ and ___ onset

A

familial, early and late

62
Q

if alzheimers is nonhereditary, it has a ___ onset

A

late

63
Q

theories behind alzheimers causes

A

genetics, head injury, lipids abnormal, low estrogen

64
Q

alzheimer symptoms

A

forgetful, emotional upset, disoriented, confused, can’t concentrate, problem solving decrease, lack of judgment

65
Q

alzheimers has a ___ onset

A

insidious

66
Q

how do we diagnose alzheimers

A

by ruling out dementia

67
Q

__% to __ % of dementias are alzheimers

A

60-80

68
Q

how quickly do people die with alzheimers

A

4-12 years

69
Q

if first-degree family has disease, __ to ___ more likely to develop disease

A

4-10

70
Q

key characteristics with alzheimers (CNS hallmarks)

A

neurofibrillary tangles and senile plaques

71
Q

what are neurofibrillary tangles

A

twisted fragments of protein within nerve cells

72
Q

senile plaques are what

A

products of dying nerve cells accumulate around protein

73
Q

other related movement disorders

A

essential tumor, benign hereditary chorea, tardive dyskinesia, drug-induced dyskinesia

74
Q

what is MD (muscular dystrophy) characterized by

A

progressive degeneration of muscle fibers and wasting of symmetric groups of skeletal muscle

75
Q

Duchennes MD is _ linked recessive and is onset in __ childhood

A

X, early

76
Q

do patients survive beyond 20 with duchennes

A

rarely

77
Q

_/3500 male births experience duchennes

A

1

78
Q

muscle wasting associated with duchennes

A

major skeletal muscles, some cardiac, smooth muscle

79
Q

____ is absent in children with duchennes. duchennes results from the gene that encodes ___

A

dystrophin (both blanks)

80
Q

cure for duchennes

A

no cure, gene therapy

81
Q

what to do/give to maximize quality of life of duchennes

A

corticosteroids, beta-2 agonists, orthopedic braces, PT, ventilator if needed

82
Q

cerebal palsy is a ____ motor disorder of the CNS mresulting in alteration in movement and posture

A

non-progressive

83
Q

cerebral palsy caused by

A

trauma, hemorrhage, anoxia, infection

84
Q

assessment of cerebral palsy

A

tonia (hyper/hypo), scissoring of legs, reflexes, seizures, development norms

85
Q

surgery associated with cerebral palsy

A

tendon release, intrathecal pump

86
Q

medication for cerebral palsy

A

baclofen

87
Q

huntingtons disease is associated with what chromosome

A

chromosome 4

88
Q

any treatment or cure for huntingtons disease

A

no

89
Q

onset for huntingtons disease

A

age 30-40

90
Q

symptoms associated with huntingtons

A

progressive loss of muscle control, chorea, dementia, death within 15-20 years

91
Q

with huntingtons, ___ is reduced in the basal ganglia, and there is also a reduction in ____

A

GABA and choline acetyltransferase

92
Q

helpful treatments with huntingtons

A

tetrabenazine, haldol, genetic counseling, PT, speech therapy

93
Q

ALS is a ___ progressive neurological disorder

A

rare

94
Q

ALS is characterized by the ___ of motor neurons

A

loss

95
Q

ALS leads to death within ___ years after diagnosis

A

2-6

96
Q

ALS means ____ and it’s also known as ____

A

amyotrophic lateral sclerosis and lou gehrigs disease

97
Q

treatments for ALS

A

riluzole

98
Q

biggest gene in body

A

dystrophin

99
Q

ApOE does what

A

moves cholesterol around the body and sweeps out AB42 from the brain

Pharm (11 decks)

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