NM PD

Question 1

Chronic progressive disorder of CNS with degeneration of ________ ______ _____ neurons and nigrostriatal pathways

Answer 1

Dopaminergic substantia nigra

Question 2

Etiology includes:

Answer 2

Infection/postencephalic
Atherosclerosis
Idiopathic
Toxic
Drug induced

Question 3

Decrease of _________ within basal ganglia corpus striatum with degeneration to ______ ______

Answer 3

Dopamine

Substantia nigra

Question 4

Loss of ______ ________ which causes excess excitatory output from ______ system of basal ganglia

Answer 4

Inhibitory dopamine

Cholinergic (ACh)

Question 5

What are the classic symptoms?

Answer 5

Bradykinesia
Rigidity (cogwheel or leadpipe)
Resting tremor
Postural instability/impaired postural reflexes

Question 6

Hoehn and Yahr: stage 1

Answer 6

Minimal/absent disability

U/L symptoms

Question 7

Hoehn and Yahr: stage 2

Answer 7

Minimal B/L or midline involvement

No balance involvement

Question 8

Hoehn and Yahr: stage 3

Answer 8

Impaired balance

Restrictions in activity

Question 9

Hoehn and Yahr: stage 4

Answer 9

All symptoms present and severe

Cannot walk or stand without assistance

Question 10

Hoehn and Yahr: stage 5

Answer 10

Bed bound or W/C bound

Question 11

Exam:

1) History
2) cog status: ______ in advanced stages, _____ deficits, ________, and _________

Answer 11

Dementia
Memory
Bradyphrenia (slow thought processes)
Depression

Question 12

Exam:

3) communication: what are you looking for?

Answer 12

Dysarthria
Hypophonia
Mask like face
Writing gets smaller

Question 13

Exam:

4) oromotor control: _________

Answer 13

Dysphagia

Question 14

Exam:

5) cardioresp. Function: decreased _______, decreased ______ expansion, ______ ______

Answer 14

Endurance
Thoracic
Ortho hypo

Question 15

Exam:
6) ROM/deformity: contractures common in _____ and ______.
Thoracic ______ and ______
Increased risk for _____

Answer 15

Flexors, adductors
Kyphosis, FHP
Fractures

Question 16

Exam:

7) sensation: problems in ______ organization, extreme _______ (akathisia)

Answer 16

Spatial

Restlessness

Question 17

Exam:

8) Vision: blurring, _____ eye pursuit, and eye irritation due to what?

Answer 17

Cogwheeling

Decreased blinking

Question 18

Exam:

9) skin integ
10) autonomic changes: increased ______/______

Answer 18

Drooling, sweating

Question 19

Exam:

11) Muscle tone: ________
12) strength: weakness due to ______
13) Motor function: ______/________ — look at ability to _____ movement, and _____ episodes

Answer 19

Rigidity
Disuse
Bradykinesia/akinesia, initiate movement, freezing

Question 20

Exam:

14) involuntary movement: ________ _______, especially ____ _____

Answer 20

Resting tremor, pill rolling

Question 21

Exam:

15) Balance: impaired postural reactions, decreased trunk ______

Answer 21

Rotation

Question 22

Exam:
16) Gait: lack of \_\_\_\_\_\_,
\_\_\_\_\_\_\_\_
\_\_\_\_\_
And \_\_\_\_ \_\_\_\_\_

Answer 22

Extension
FOG
Festination
Fall risk

Question 23

Exam:

17) fatigue: increased with _____ or ____ ______

Answer 23

Stress

High effort

Question 24

Medications: Sinemet (Levadopa/carbidopa): provides ________, crosses the ______, decreases the effects of ______

Effects prolonged with ____ _____ diet

Answer 24

Dopamine
BBB
PD
Low protein

Question 25

Medications: Sinemet (Levadopa/carbidopa): | What are the ADRs?

Answer 25

``` N/V Ortho hypo Cardiac arrythmias Involuntary movements Psychoses Abn behaviors (hallucinations) ```

Question 26

Dopamine agonists do what? | Examples?

Answer 26

Enhance the effects of sinemet Bromocriptine, pergolide mesylate

Question 27

Anticholinergic drugs control ______

Answer 27

Tremor

Question 28

Amantadine increases what?

Answer 28

Dopamine release

Question 29

Selegiline is a ______ _____ _____ that increases ______

Answer 29

Monoamine oxidase inhibitor | Dopamine

Question 30

Deep brain stimulation in ______ or ______ ______

Answer 30

Thalamus | Subthalamic nuclei

Question 31

Teach ______ strategies to unlock ________ such as using _____ stimulation’s

Answer 31

Compensatory Freezing Auditory

Question 32

Improve strength, especially ______

Answer 32

Rotation