Parkinson Disease Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Parkinson Disease > Flashcards

Flashcards in Parkinson Disease Deck (42):
1

What are some causes of sudden declines in PD symptoms?

Not taking meds

Intercurrent illness - eg UTI

Dehydration

Poor nutrition

Deconditioning

2

What are the advanced therapies for PD?

Apomorphine infusion (dopamine agonist)

Deep brain stimulation - stimulate the globus pallidus or subthalamic nucleus

 

 

3

What is the main difference between dementia with Lewy bodies and Parkinson disease?

The dementia preceeds the movement disorder in DLB, in Parkinson disease the movement disorder occurs first

4

What is restless legs?

Deep noring pain in the legs at night that is relieved by movement

5

What is the purpose of a decarboxylase inhibitor?

Stops metabolism of levedopa in the periphery to prevent side effects

6

What happens to the eyes in PD?

Reduced blink rate

Hypometric saccades

Saccadic intrusion into smooth pursuit

7

What the incidence of Parkinson disease?

100-200 per 100,000 over 40 years

8

How long might anosmia preceed the movement symptoms?

15-20 years

9

What is the pathology of PD?

Loss of dopaminergic neuron in the substantia nigra, therefore dopamine production, in the basal ganglia

10

What are some causes of PD or PD like syndrome?

Genetic

Brain injury

Pesticide exposure

11

What does a festinating gait look like?

Difficult to initiate walking

Increasing speed of steps

+/- Fall

12

How does the levodopa regimen change with the progression of the disease?

Increase dose frequency as endogenous dopamine production decreases so they have exogenous dopamine most of the time

13

What is the ratio of male to female in the incidence of Parkinson disease?

3:2

14

What is the first line therapy for PD?

Levedopa

15

What are some nocturnal symptoms of PD?

Enacting their dreams in bed

Restless legs

Reduced turning in bed

 

16

What does tremor predominant PD refer to? What are the implications?

Predominance of tremor at presentation, usually slower progression of disease

17

What is the Hoen-Yhaer staging?

Staging for PD severity

Uses the pull test

18

What anti-emetic is levodopa accompanied with?

Domperidone

19

Can PD be diagnosed without a tremor?

Yes

20

What does asymmetry of motor sign indicate?

More likely PD than an other cause of Parkinsonism

21

What is the side effect of levodopa?

Dyskinesia

Nausea

22

What is the most effective intervention for improved walking and falls prevention?

Physio

Exercises requiring balance

23

What is the name of the facial affect PD patient might exhibit?

Hypomimia

Blank face

24

What is madopar?

Levodopa and benserazide

25

What are some other PD medications?

COMT inhibitors

Selective monoamine oxidase type B inhibitors

Dopamine agonists (pramipexole)

Anticholinergic

Amantadine

26

What are the cardinal feature of PD?

Tremor

Rigidity

Bradykinesia

Postural instability

27

What is the mean age of diagnosis?

Around 70

28

What is the main symptomatic relief provided by levodopa?

Reduced bradykinesia

29

What causes acute akinesia in PD?

Not taking their medication

Intercurrent illness

30

How does speech change in PD?

Lower volume

31

What is dystonia?

Involuntary muscle contraction involving abnormal movements and postures

32

What is dystonia is the setting of PD likely due to?

Drugs

33

What is the difference between GEM and Fast track?

GEM is slow stream for the less motivated patient

Fast track is for the highly motivated patient

34

What are the features of a PD gait?

Shuffling +/- festinating/freezing

Brady and hypokinetic

Camptocormia (stooped posture)

Loss of arm swing

Increase in tremor

Difficult crossing threshold

Slow turning

35

What is the pull test?

When the patient is pulled back they take multiple steps (instead of one)

36

What are the most troubesome non-motor features of PD?

Orthostatic hypotension

Urinary frequency

Constipation

37

What are the side effects of dopamine agonists?

Hypersexuality

Gambling

Binge eating

Shopping

38

An increase in tremor when walking indicates what?

PD is most likely over other movement disorders

39

How does dementia develop in PD?

It develops after movement symptoms in all PD patients

40

What is the prevalence of depression in PD patients? How it is treated?

40%

Treat with SSRI

41

42

What is on-off syndrome?

Episodes of decreased mobility despite medications

Can prepitate failure to turn "on" if for a prolonged period