Parkinson's Flashcards

(41 cards)

1
Q

number one risk factor for Parkinson’s

A

aging 2-4% risk >60 years

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2
Q

do males or females get Parkinson’s more

A

Males 3:2 (M:F)

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3
Q

etiology of Parkinson’s

A

idiopathic>>>>>>genetic

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4
Q

what does Parkinson’s often start with/first sign

A

UUNILATERAL resting tremor (don’t HAVE to start our with but often do 75%)

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5
Q

when looking at brain, what is a hallmark to Parkinson’s

A

progressive Lewy Body accumulation starts in brainstem and then goes up to frontal cortex and then works it’s way back to occipital cortex (most found in brainstem)

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6
Q

hypothesis as to why get tremor

A

some people are more sensitive to switch to loss of dopamine

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7
Q

list four classical clinical features of Parkinson’s

A

Bradykinesia Muscular Rigidity Postural Instability Resting Tremor

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8
Q

describe bradykinesia

A

slowness of executing movement “paucity” of movement

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9
Q

describe muscular rigidity

A

increased tone velocity-independent cogwheel=rigidity+tremor

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10
Q

describe postural instability

A

primary NOT due to visual, proprioceptive, vestibular, cerebellar deficits

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11
Q

describe rest tremor

A

“pill-rolling” UNILATERAL/symmetric

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12
Q

common appearance of gait in Parkinson’s

A

narrow stance, small-shuffling steps, stooped over

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13
Q

what percent of Parkinson’s patients present with resting tremor initially and thought disease

A

75%

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14
Q

non-motor features of Parkinson’s

A

see picture

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15
Q

common non-motor features of Parkinson’s

A

fatigue, saliva, nocturia

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16
Q

T/F everyone with Parkinsonism has Parkinson’s

A

False

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17
Q

Possible causes of Parkinsonism or differential dx to Parkinson’s

A

stroke in areas of the brain that are affected in Parkinson’s (substantia nigra, cerebellum, striatum, caudate putamen) reaction to drugs (block dopamine) (i.e. antipsychotics)

18
Q

how to tell if Parkinsonism due to Parkinson’s or stroke

A

onset stroke get all of a sudden Parkinson’s is gradual onset

19
Q

how to tell if Parkinsonism due to Parkinson’s or drugs

A

are features presenting symmetrically or asymmetrically symmetrically due to drugs asymmetrically due to Parkinson’s

20
Q

why do you want to get definitive dx of Parkinson’s when looking at neurodegenerative disorders when treatment basically the same for all of them

A

prognosis quality of life Parkinson’s could still live 30 years Other neurodegenerative disorders 8-10 years

21
Q

T/F diagnosis of Parkinson’s is clinical

22
Q

T/F diagnosis of Parkinson’s is from good hx and physical

23
Q

define Parkinsonism

A

bradykinesia in combination with at least 1 of rest tremor or rigidity

24
Q

are reflexes impaired in those with Parkinson’s

25
diagnostic criteria of Parkinson's
see picture
26
Parkinson's diagnostic pearls
see picture
27
what best slows down the progression of Parkinson's
exercise
28
goals of management of Parkinson's
optimal quality of life patient-specific
29
T/F medication adjustment over time is the norm when treating Parkinson's
true
30
Management strategies of Parkinson's
see picture
31
Parkinson's medications
see picture
32
rule when starting medications in Parkinson's
start low and go slow
33
common side effects of selected dopaminergics
see picture
34
potential side effects of dopamine agonists like pramipexole (mirapex)
impulse controle disorders so impulsive shopping, gambling, hypersexuality, or binge eating
35
define Parkinson's
neurodegenerative disorder associated with loss of dopaminergic neurons in brainstem and accumulation of Lewy bodies throughout brain
36
mainstay of pharmacotherapy for Parkinson's motor symptoms
dopaminergic medications
37
mechanism of Parkinson's
dopamine neurons die so less dopamine less dopamine (inhibitory) means failure to inhibit Ach (excitatory) in basal ganglia thus increase GABA release (inhibitory)
38
where is loss of pigment cells seen in Parkinson's
substantia nigra which projects to the striatum
39
age of onset of symptoms in Parkinson's
45-65 years
40
facial involvement in Parkinson's
relatively immobile face/fixed facial expressions kinda giving you the death stare
41
drug treatment of Parkinson's
see picture (from pance prep pearls)