Parkinson's Flashcards Preview

Hugh's MD1 Neuro > Parkinson's > Flashcards

Flashcards in Parkinson's Deck (17):
1

Alpha-synuclein does what in Parkinson's?

A mutation in this gene leads to Parkinson's

2

Why do you have to increase the dose of L-DOPA over time?

Its effectiveness declines with time as dopaminergic nerves continue to degenerate

 

2

Why would you use a MAOb inhibitor in Parkinson's?

To inhibit the inactivation of dopamine at the synapse

3

What are some side effects of dopamine agonists?

Similar to L-DOPA but includes hallucinations, confusion, delirium, nausea and hypotension

4

What is the problem with giving Levodopa on its own? How can you overcome it?

90% is metabolised in the periphery

 

Give with a peripheral dopa decarboxylase inhibitor like carbidopa

4

What is MPTP?

A toxin that kills dopaminergic cells and causes Parkinson's

5

What are some non-motor signs and symptoms of Parkinson's?

Cognitive deficiencies

Depression - both due to dopamine and psychogenic

Raised anxiety levels

Olfactory deficiencies

Sleep disturbances

Fatigue

Pain

Bowel and bladder problems

Sexual dysfunction

6

T/F Degeneration is usually symmetrical

False, asymmetrical

7

What is the cellular cause of Parkinson's?

Degeneration of the dopaminergic nerves in the substantia nigra

- causes reduced dopamine

 

8

What does amantadine do?

Enhances release of dopamine

10

What is the management goal in Parkinson's?

Symptomatic relief via replacement of dopamine at the synapse

11

What are some early signs of Parkinson's?

Olfactory deficiencies

Bowel and bladder problems

12

What is the major drawn back with L-DOPA treatment?

The convertion of L-DOPA into dopamine produces ROS with accelerates the degeneration of dopaminergic neurones

13

Why are dopamine receptor agonist prefered in younger people?

To slow ROS mediated degeneration

15

The development of motor signs indicate what in terms of the progression of the disease?

80% of dopaminergic neurons have degenerated

16

What is the problem with using dopamine receptor agonists instead of L-DOPA?

Non-specific activation of dopamine receptors throughout the brain

17

What are some motor signs and symptoms of Parkinson's?

Tremor

Rigidity of limbs

Bradykinesia (slow movement)

Impairment of postural reflexes

Facial - impassive, no blinking

Speech - Monotonous, hypophonic

Movement - deceased manual dexterity