PD (MedBridge)

Question 1

Direct pathway

Answer 1

• Disinhibits motor tahalmus
• Activates thalamo-cortex
• Activates motor cortex
• Facilitates movement

Question 2

Indirect

Answer 2

• Inhibits motor thalamus
• Inhibits thalamo-cortex
• Inhibits motor cortex
• Inhibits movement

Question 3

Hoehn and Yahr Classification of Disability

Answer 3

1 Unilateral
1.5 Unilateral and axial
2 Bilateral
2.5 Bilateral with recovery on pull test
3 Balance impairments
4 Severe impairment but still able to stand and amb independent
5 Bedridden/WC bound

Question 4

Vascular PD réponse to Levadopa

Answer 4

Poor response

Question 5

UPDRS subscales

Answer 5

• Mentation, behavior and mood
• ADLs
• Motor scales

Question 6

Neurodegenerative features of non-parkinsonian diseases

Answer 6

• Marked symmetry early
• Early onset of dementia of PI
• Truncal sx > limb sx
• Motor apraxia
• Autonomic signs early on in disease

Question 7

PSP sx
Response to LD
Median survival

Answer 7

• Early postural instability and falls
• Limitation of vertical gaze
• Early cognitive involvement
• Emotional and personality changes
• *Positive response initially to LD
• *Median survival = 5.3 years

Question 8

MSA sx
Response to LD
Median survival

Answer 8

• Urinary dysfunction
• Autonomic failure = OH
• Sustained gaze evoked nystagmus
• *Cognitive dysfunction not likely
• *Poor response initially then it repsonds to LD
• *Median survival = 9-10 years

Question 9

MSA-P

MSA-C

Answer 9

MSA-P: predominant parkinsonian sxs

MSA-C: predominant cerebellar sxs (ataxia, rigidity, spasticity = tolivopontocerebellar atrophy)

Question 10

CBD sx
Response to LD
Median survival

Answer 10

• Typically starts unilaterally and progresses bilaterally
• Limb apraxia and progressive dementia is very common
• Prominent sensory impairments (spatial neglect, alien limb)
• Downward gaze not normally affected; typically involves horizontal and upward gaze
• *Poor response to LD
• *Median survival = 6-8 years