PD Flashcards
1
Q
What criteria is used for diagnosis of PD
A
UK PD society brain bank clinical diagnostic criteria
2
Q
Criteria for diagnosis of Parkinsonism syndrome
A
Bradykinesia AND At least 1 of: - rigidity - tremor - postural instability not caused by visual, vestibular, proprioceptive or cerebellar pathology
3
Q
Exclusion criteria for PD (12)
A
Unilateral for >3 years History of frequent strokes History of encephalitis Oculogyric crisis Onset of symptoms when starting antipsychotics Remission period Supranuclear gaze palsy Cerebellar signs Babinski sign Radiological evidence of brain tumour or hydrocephalus No response to levidopa Severe autonomic signs
4
Q
Supportive positive criteria for PD diagnosis
A
Unilateral onset Rest tremor Progressive Asymmetry >70% response to levodopa Levodopa induced chorea
5
Q
What features make vascular Parkinsonism more likely than idiopathic PD (9)
A
Older Shorter duration Symmetrical gait abnormality <70% levodopa response More prone to falls More prone to dementia Tremor not a main feature Incontinence Pyramidal/corticospinal tract signs more common
6
Q
Who is involved in the MDT for Parkinsonism
A
GP Neuro specialist (initiates medication) SALT PT/OT Specialist nurse (follow up for dose alterations) Dietician
7
Q
Features of progressive supranuclear palsy
A
Vertical diplopia
Falls
8
Q
Features of multiple systems atrophy
A
Cerebellar signs
Early severe autonomic dysfunction e.g postural hypotension, incontinence, gastroparesis
9
Q
Features of cortical basal ganglionic degeneration
A
Comprehension difficulty
Alien hand syndrome
10
Q
Features of Lewy body dementia
A
Cognitive decline Visual hallucinations R.E.M. Sleep disorder Falls Highly fluctuating symptoms
11
Q
Stages of PD
A
1- mild tremor 2- bilateral, gait disturbance 3- bradykinesia 4- need more support with ADLs 5- can't stand or walk
12
Q
Palliative needs in PD
A
Pain
Constipation
Mood
Swallowing
