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Neurology Year 3 > Parkinsonism > Flashcards

Flashcards in Parkinsonism Deck (37)
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1

What are some environmental risk factors for Parkinson's.

Prior head injury, pesticides, rural living, well drinking, B blockers,

2

What are some environmental factors that decrease your risk of Parkinson's?

Tobacco smoking, Coffee, NSAIDs, Ca2+ blockers, Alcohol

3

What are some genetic risk factors for Parkinson's.

+ve Family History

4

What genes are related to Parkinson's?

LRRK2 - autosomal dominant
PARKIN - Autosomal recessive

5

What does management and treatment involve in Parkinson's?

No curative treatment entirely symptomatic relief.

6

What is the main aim of symptomatic relief?

To increase intracerebral dopamine concentration or stimulate dopamine receptors

7

What are the mainstay drugs for symptomatic treatment of Parkinsons?

Levodopa
Dopamine Agonist
MAO B inhibitors

8

What is Levodopa?

A precursor to dopamine used to treat bradkinetic symptoms of parkinsonism.

9

List some common side effects of Levodopa/ Dopamine Agonists

Nausea
Oedema
Daytime sleepiness

10

When should dopamine agonists be avoided?

In cognitive impairment as increased risk of hallucination.

11

If someone with Parkinsonism presents with dementia like symptoms what is the treatment?

Acetylcholinesterase inhibitor

12

Give an example of an acetylcholinesterase inhibitor used in Parkinson's.

Rivestigmine

13

If someone with Parkinson's presents with depression what is the treatment?

SSRI
Citalopram
Setraline

14

If someone with parkisnons presents with psychosis what is the treatment?

Clozapine - Cognitive features
Quetiapine - Hallucination and Delusions only

15

If someone with parkinsons presents with sleep disorders what is the treatment ?

Melatonin

16

If someone with parkinsons presents with fatigue what is the treatment?

Methylphenidate
Modanfil

17

List some red flags in a patient with parkinsons.

Frequent falls
Severe axial limb involvement
Autonomic dysfunction
Psychosis
Dysfunction within Spinal columns i.e corticospinal

18

Where is predominantly affected in vascular parkinsons?

Lower limbs

19

Describe presentation of vascular Parkinsonism.

Rest tremor is uncommon
Sign of brain lesion I.e spasticity hemiparesis
Poor levodopa response
Lower limbs affected

20

How is vascular parkinsons diagnosed?

Structural brain imaging involved.

21

What is the key thing to note when a diagnosis of drug induced parkinsons is possible?

Onset after exposure to a new drug

22

Describe drug induced Parkinson's.

Coarse symmetrical postural tremor
Improvement upon withdrawal of drug

23

What is a common cause of degenerative Parkinson's?

Multi System Atrophy

24

When does multi system atrophy present?

60/70s

25

What are the main features of Multi system atrophy ?

Dysautonomia
Cerebellar features
Parkinsonism

26

Describe the presentation of multi system atrophy.

Hyperflexia - extensor plantar
Pyrimidal signs
Axial involvement
Jerky postural tremor
Severe dysarthria dysphonia

27

What is dysarthria?

Muscles required to speak are paralysed so unable to formulate words properly.

28

What is dysphonia?

Abnormal voice often hoarse

29

How does Multi system atrophy respond to levodopa?

Short lived

30

What might appear on the MRI of someone with Multi System Atrophy?

Hot Cross bun sign
Cerebellar and pontine atrophy