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Y3 NEUROLOGY > Parkinson's Disease > Flashcards

Parkinson's Disease Flashcards

1
Q

What is Parkinson’s disease?

A

Neurodegenerative disease that arises due to dopaminergic neurone loss in the brain

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2
Q

Which part of the brain does dopaminergic loss occur in Parkinson’s disease?

A

Substantia nigra pars compacta

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3
Q

Is Parkinson’s disease typically a cerebellar, pyramidal tract or extra-pyramidal tract problem?

A

Extra-pyramidal

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4
Q

List the triad of the “Parkinsonian syndrome”

A

Rigidity
Bradykinesia
Resting tremor

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5
Q

List clinical motor features of Parkinson’s disease

A 
Resting tremor
Muscle rigidity +/- cogwheeling
Bradykinesia
Gait
Postural impairment
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6
Q

Tremor-dependent Parkinson’s disease carries better prognosis than tremor-independent Parkinson’s disease. True/False?

A

True

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7
Q

List clinical non-motor features of Parkinson’s disease

A 
Olfactory dysfunction
Cognitive impairment
Psychiatric symptoms - hallucinations
GI dysfunction
Depression
Sleep problems
Pain and fatigue
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8
Q

Diagnosis of Parkinson’s disease occurs with the onset of motor symptoms. True/False?

A

True

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9
Q

What is the pathological name given to the mis-folded protein aggregates that accumulate in the brain to cause Parkinson’s disease?

A

Lewy bodies and neurites

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10
Q

Parkinson’s disease is the most common neurodegenerative disease. True/False?

A

False

2nd most common after Alzheimer’s disease

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11
Q

Which gene mutations are the most common causes of dominant and recessive Parkinson’s disease respectfully?

A

LRRK2 (dominant)

Parkin (recessive)

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12
Q

There are no neuroprotective/disease-modifying drugs for Parkinson’s disease. True/False?

A

True

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13
Q

List some drugs that can be used for symptomatic treatment of Parkinson’s?

A 
LEVODOPA
Dopamine agonists e.g. Selegelline
Monoamine oxydase type B inhibitors
Amantodine
Tolcapone
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14
Q

Which agents can be useful for tremor in Parkinson’s disease?

A

Clozapine

Anticholinergics

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15
Q

List side effects of levodopa and dopamine agonists

A

Nausea
Daytime somnolence
Oedema

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16
Q

When do motor features appear during the coarse of Parkinson’s?

A

In late Parkinson’s Disease

After 60-80% of dopamine cells are dead

17
Q

Which sign on imaging would suggest a diagnosis of Parkinson’s Disease?

A

Dark black pigment loss (loss of substantia niagra)

18
Q

What is the action of drugs used in Parkinson’s Disease?

A

Increase dopamine concn or stimulate dopamine receptors.

19
Q

Parkinson’s is a selective neurogenic disease. True/ False?

A

False

Variety of neurotransmitters affected, including dopamine, noradrenaline, acetylcholine, serotonin

20
Q

What is typically the first clinical sign to appear in Parkinson’s Disease?

A

Non-motor sign: GI dysfunction

21
Q

What are the main subtypes of Parkinson’s Disease?

A 
Tremor dominant (absence of other motor symptoms)
Non-tremor dominant (akinetic rigidity + postural instability)
Mixed/ indeterminate
22
Q

Which diagnostic tests may be helpful in Parkinson’s disease?

A

Structural brain imaging (view basal ganglia)

SPECT (DaTSCAN)

23
Q

Which symptoms in a patient would make a diagnosis of Parkinson’s Disease less likely?

A

Early onset bulbar problems
Early dementia and hallucinations
Eye movement disorder
Intrusive early autonomic problems

24
Q

What is classed as ‘Parkinsonism’?

A

Bradykinesia and 1 of following:
Resting tremor
Rigidity (cog-wheel or lead pipe)
Postural instability

25
Q

List the risk factors of Parkinson’s Disease

A 
Increasing age
Family history
Male
Environmental factors
Genetics
26
Q

Drugs used to manage Parkinson’s disease are associated with what long term complications?

A

Motor fluctuations
Non-motor fluctuations
Dyskinesia (levodopa)
Drug induced psychosis (e.g. dopamine agonists- impulse control disorders, hallucinations)

27
Q

List some non-pharmacological therapies that can be used in Parkinson’s Disease?

A

Deep brain stimulation
DUODOPA
Continuous apomorphine infusion

28
Q

A tremor in which anatomical location is particularly suggestive of Parkinson’s Disease?

A

Chin

29
Q

How would you go about eliciting a resting tremor in Parkinson’s?

A

Ask the patient to count backwards from 100

30
Q

Which subset of Parkinson’s involves degeneration of midbrain and vertical gaze palsy?

A

Progressive supranuclear palsy

31
Q

Which subset of Parkinson’s involves orthostatic hypotension and a poor response to levodopa?

A

Multiple system atrophy

32
Q

Which drug should be used to control vomiting in Parkinson’s?

A

Domperidone - dopamine agonist that doesn’t cross the BBB

33
Q

Which medication should be used for a patient on Parkinson’s therapy with acute psychosis?

A

Quetiapine

Y3 NEUROLOGY (22 decks)

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