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Flashcards in Parksinsons Deck (68)
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31

where are lewey bodies found in parkinsons?

not confined to the brain, they are also present in spinal cord and peripheral nervous system

32

what are lewey bodies?

misfolded alpha sinuclein, which is insoluble and aggregated. These form intracellular inclusions

33

what does pigment loss correlate with?

dopaminergic cell loss

34

greatest risk factor of parkinsons?

age

35

male to female?

more common in males

36

greatest genetic risk factor for PD

mutations in GBA

37

what is treatment in PD aimed at doing ?

enhancing intracerebral dopamine concentrations or stimulate dopamine receptors

38

which drug class associated with oedema?

dopamine agonists

39

which drug associated with dyskinesia? (writhing movements)

levodopa

40

what is the "on-off effect" of levodopa

alterations between periods of good motor symptom control and periods of reduced motor symptom control

41

PsyChosis in PD is most efficiently managed with

Clozapine

42

motor symptoms in PD?

bradykinesia
rest tremor
rigidity
postural and gait impairment (stooped posture and show, shuffling gait with reduced arm swing)

43

Slowness of movement with progressive loss of amplitude or speed during aWempted rapid alternaLng movement of body segments

BRADYKINESIA

44

how can you assess bradykinesia?

can be assessed by asking the patient to perform some repetitive movements as quickly and wisely as possible

45

decreased facial expression and eye blinking ?

hypomimia

46

what happens to rhythmic oscillatory tremor on voluntary active movement

disappears

47

what is re emerging tremor?

tremor reappears after hands held out

48

is head tremor typical for PD?

no

49

what is cog wheel rigidity

"Cogwheel" rigidity occurs when there is also a tremor and is characterized by a "stop and go" effect during a range of motion maneuver. Felt especially at the wrist

50

why do you get a stooped posture?

impaired postural reflexes

51

what is the parkinsonian gait like ?

slow, shuffling gait with a narrow base

52

what is hyposmia?

reduced ability to smell (hypnosemia)

53

what are premotor symptoms to ask about?

REM sleep behaviour, loss of smell, constipation

54

exposure to what can be a risk factor for parkinsons?

manganese, pesticides

55

do you get dementia early in the disease course?

no

56

investigations for parkinsons?

structural brain imaging
possibly structural brain imaging
dopamine functional imaging is unable to distnguish PD from other causes of degeneratve Parkinsonism, but should be normal in essenLal tremor, dystonic tremor, psychogenic parkinsonism.
positive levodopa challenge
genetic testing where appropriate

57

what is vascular parkinsonism?

parkinsonism affects mainly the lower limbs. rest tremor is uncommon. get a poor levodopa response

58

does parkinsonism tend to be symmetrical or assymetrical?

symmetrical, although can start unilateral

59

what drugs can cause parkinsonism?

any drugs that block the action of dopamine (especially neuroleptic drugs)

60

what improves essential tremor?

alcohol and beta blockers