PD Flashcards

Question

PD: hoehn and yahr stage: 2

Answer 1

bilateral or midline involvement | w/out impairment of balance

Answer 2

bilateral disease mild-mod disability w/ impaired postural reflex physically indep

Answer 3

severely disabling disease | still able to walk and stand unassisted

Answer 4

confined to bed or W/c unless aided

Answer 5

``` older age at dx early cog deficits associated co morbidities dec repose to dopamine replacement greater baseline impairment dx of MSA or PSP rigidity and bradykinesia ```

Answer 6

right sided tremor is first symptoms

Answer 7

atypical parkinsons -loss neurons and gliosis --> neurofibrillary tangles in cerebral cortex, decreased blood flow (frontal lobe), decreased oxygen utilization in central structures typical onset after 60, M>W severe disability 3-5 years after onset

Answer 8

unsteadiness of gait w/ unexplained fallings

Answer 9

PSP progresses more rapidly, severe speech and swallowing, minimal repose to PD meds, may retropulse lack of vertical eye movements and saccades, eventual loss of convergence, small pupil, saccadic smooth persuit

Answer 10

``` age at onset bradykinesia tremor rigid apathy cog impair ```

Answer 11

striatonigral degeneration shy drager syndrome oliviopontocerebellar degen

Answer 12

MSA -P: mild tremor, illness begins w/ hypotension MSA-C: cerebellar ataxia, dysphonia w/ stridor present *wheter they are predominately parkinsonism or cerebellar ataxia either: autonomic dysfunction: postural hypotension, bladder, dysfunction, fecal incontinence

Answer 13

symmetry of signs early presence of autonomic dysfunction minimal tremor lack of response and dopamine

Answer 14

``` eye movements, PSP lack of vertical, or eye tremor tandem balance, bicycle, potential MSA response to meds speed of progression lack of progress sever hypotension w/ postural changes ```

Answer 15

1. med 2. deep brain stim 3. PT

Answer 16

not started till later

Answer 17

neuroprotective benefits | may prevent breakdown of existing DA

Answer 18

increase update of existing dopa | side effects include compulsive behavior and hallucinations- alert MD, needs to be altered

Answer 19

1/2 life = 4 hours, protein interferes w/ binding/absorption side effect: orthostatic hypotension complications: wearing off, dyskinesia, dystonia *motor complications occur in 50% w/ PD after 5 years on levadopa

Answer 20

on: meds working off: meds not working 15-20% of its have severe motor fluctuations leading alternating periods of dyskinesia and immobility

Answer 21

slows breakdown of levadopa | heals w/ wearing off

Answer 22

antiviral for dyskinesia (which is result of meds)

Answer 23

most commonly prescribed drugs are hypotensive agents

Answer 24

if you learn a motor program wrong the first time, it is a lot harder to learn the correct one w/ practice w/out dopa, PD learn wrong first time compared to on dopa

Answer 25

deep brain stim sx implant of pacemaker send electrical impulse to stim brain implanted globus pallidus internen or subthlamic nuclei

Answer 26

good response to levodopa but have severe motor fluctuations that can't be controlled w/ meds alone interlate to meds <70 yrs

Answer 27

cog/psych problems atypical PD, speech or swallowing progblems frequent falls decreased motor performance when on levadopa

Answer 28

``` prevention decreased fx mobility including gait dev pain (shoulder: posture. back: rigid) posture balance ```

Answer 29

increase release of dopamine increased number of dopamine receptors, more efficient w/ exercise **exercise must start early

Answer 30

``` improve cog fx prevent depression improve sleep quality decrease constipation decrease fatigue improve motor performance improve drug efficiency optimize dopaminergic system ```

Answer 31

MoCA >/= 26/30 normal use score to justify ST referal

Answer 32

abnormal sustained muscle contraction | document body part, trigger, how it interferes /w movement

Answer 33

tendency to fall backwards

Answer 34

excessive movements, wristhing disorder caused by meds doc where, how if interferes w/ function

Answer 35

common related to postural changes eval thoracic mobility, scapular mobility, SHR

Answer 36

freezing of gait | 6MWT

Answer 37

16 items eval 1. gait of daily living 2. freq/severity of FOG 3. freq and festinating gait and rln to falls 4. frequency and severity of alls

Answer 38

"do you feel your feet get glued to the floor while walking, making a turn or when trying to initiate walking?" reliable for ID freezers

Answer 39

``` add turns dual task wake through doorway/narrow space walk over lines in ground or change in floor type add urgency ```

Answer 40

``` trunk rotation step length arm swing freezing festination shuffling lack of WS ```

Answer 41

0.88m/s correctly predicted 70% of pts as community walkers ``` MDC value (95%) comfortable gate speed = .18m/s fast gate speed = 0.25 ms/ ```

Answer 42

22/30 fall risk 15/30 fallers in PD pts score 0-3, severe imp to normal amb

Answer 43

14 dynamic balance assessments 0 severe, 1 mod, 2 normal <20/28 fall risk if L and R, lower score used for total score

Answer 44

fall risk for PD | >9.68 seconds

Answer 45

1. preclinical - neuroprotection 2. early/mod - neurorepair 3. late - adaption

Answer 46

treatmill training high intensity resistance training cycle aerobic exercise

Answer 47

increased gait speed, stride length after 1 session feasible, safe, improve gait speed, stride length improve QOL, UPDRS, long term carryover

Answer 48

forced exercise for PD global improvements w/ high intensity aerobic exe cerise on tandem bike improve bimanual coordination 4 weeks decreased tremor, rigidity, bradykineasia

Answer 49

safe, muscle force production, pain, serum creatine kinase hypertrophy, strength, improved speed w/ stair descent, improved 6MWT decreased brady, improved QOL improved rise from chair for CRE

Answer 50

``` postural extension hip ext, ab knee ext gastric/soleus trunk ext ```

PD Flashcards

(75 cards)