parkinsons disease W2

Question 1

parkinsons motor symptoms?

Answer 1

bradykinesia (slowness of movement)
rigidity
tremor
postural instability

Question 2

non-motor symptoms of parkinsons?

Answer 2

cognitive change
depression, anxiety
REM sleep behaviour disorder (vivid dreams, hallucinations)
constipation
pain

Question 3

parkinsons clinical appearance

Answer 3

rigidity and trembling of head and extremities
forward tilt of trunk
reduced arm swing
shuffling gait with short steps

Question 4

lead pipe rigidity?

Answer 4

increased tone throughout body

Question 5

neuropathology of parkinsons?

Answer 5

lack of dopamine
pallor of substantia nigra due to degeneration

Question 6

how do lewy bodies appear in histology

Answer 6

bright pink structures in cytoplasm of neuron, surrounded by pale halo

Question 7

where do lewy bodies spread?

Answer 7

first appear in medulla and olfactory bulb, spread to pons, midbrain, limbic lobe, neocortex

Question 8

basal ganglia structures?

Answer 8

thalamus
globus pallidus
subthalamic nucleus

Question 9

what pathway is affected in parkinsons?

Answer 9

pathway between substantia nigra and basal ganglia:
nigrostriatal pathway

Question 10

function of basal ganglia?

Answer 10

circuitry processes signals that flow from the cortex allowing the correct execution of voluntary movements

Question 11

which neurons are destroyed in parkinsons? what does this cause?

Answer 11

dopamine producing neurons
other neurotransmitter pathways become overactive

Question 12

where is dopamine produced and what does it inhibit?

Answer 12

substantial nigra
inhibits GABA

Question 13

what does GABA do?

Answer 13

stimulates skeletal muscle

Question 14

what does increased GABA cause

Answer 14

symptoms of parkinsons

Question 15

difference in starting location of lewy bodies between DLB and parkinsons?

Answer 15

DLB - cortical
parkinsons - brain stem

Question 16

how many people with parkinons develop dementia?

Answer 16

30%

Question 17

what is development of dementia in those with parkinsons associated with?

Answer 17

age
disease duration
visual illusions/hallucinations
fluctuation in symptoms
paranoia/delusions
may be exacerbated by treatment, particularly dopamine agonists

Question 18

what are parkinson-plus syndromes?

Answer 18

syndromes which look like parkinsons but have additional features

Question 19

progressive supranuclear palsy symptoms?

type of atypical Parkinson’s

Answer 19

problems with balance
limited eye movements
appearing surprised in facial expression

Question 20

multiple system atrophy symptoms?

Answer 20

autonomic disturbance
dizziness
falls
coordination
ataxia
slurred speech

Question 21

corticobasal syndrome symptoms?

Answer 21

stiffness
slowness of movement (often asymmetrical)
difficulty solving problems
difficulty with coordination

Question 22

general function of Parkinson’s drugs?

Answer 22

increase dopamine
(dopamine replacement therapies)

Question 23

gold standard treatment for parkinsons?

Answer 23

levodopa (with carbidopa)

Question 24

what happens if you take levodopa on its own? how is this fixed?

Answer 24

broken down in periphery. must be given with carbidopa which stops this breakdown allowing levodopa to cross blood brain barrier

Question 25

what is levodopa converted to in the brain?

Answer 25

dopamine

Question 26

what drugs stop the breakdown of dopamine? (for parkinsons)

Answer 26

MAO-B inhibitors (enzyme inhibitors) rasagiline and selegiline

Question 27

drugs for parkinsons that directly stimulate the post synaptic receptors? (dopamine agonists)

Answer 27

pramipexole
ropinirole
rotogotine
apomorphine

Question 28

drugs for parkinsons that stop reuptake of dopamine?

Answer 28

entacapone
opicapone

Question 29

how is levodopa taken?

Answer 29

oral tablet