Parkinsons Flashcards
What is Parkinson’s
Loss of dopaminergic neurones from substantia nigra
What is the pathology of Parkinson’s
Gradual depletion of neurones in the substantia Niagra decreasing dopamine secretion
Can be caused by encephalitis and toxins
What are the risk factors for parkinsons
Age over 65
Male
Pesticide exposure (Gardener’s)
Family history
Antipsychotics/Metaclopromide
What is the triad of features found in Parkinson’s
Bradykinesia
Lead pipe rigidity
Resting tremor
What is cog wheeling characterised by (Jerk motion on assessment)
Lead pipe rigidity w/ resting tremor
What are the gait features of Parkinson’s
Small steps
Shuffling
Slow movement
Tremor
What is festination
Ability to increase speed working in a particular direction
What are the non motor features of Parkinsons
Sleep apnoea
postural hypotension
Constipation
Erectile dysfunction
Early Anosmia
How would you diagnose Parkinsons
1 = Bradykinesia w/ lead pipe rigidity and tremor 2 = exclude neurological Hx 3 = L dopa response, tremor, progressive and hallucinations
What is the management of Parkinson’s
Levodopa w/ Carbidopa (Decarb inhibitor) Dopamine agonist (moa-B) MDT care
What are the side effects of LEVODOPA
Hypotension and palipitation Wearing off Psychosis/ restlesseness Dykinesias (uncoordinated movements) Anorexia Dry mouth
What is a differential for Parkinsons
Lewy body dementia
Multiple system atrophy
How can you differentiate Lewy body to parksinsons
Parkinson = Parkinsonism then dementia
LWB = Dementia then parksinsonism
What is Multiple system atrophy
Parksinsnism with atonic bladder
Postural HTN and CEREBELLAR Signs
What neurones are lost in Parkinsons
Dopaminergic neurones from substantia nigra
