Study Parkinson's Disease Flash Cards

 
Pile Management Card
Parkinson's Disease

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Deep brain stimulation (DBS)?
ELECTRODES IN BRAIN USED TO BLOCK SYMPTOM CAUSING NERVE SIGNALS; TOTAL SUPPRESSION OF TREMOR IN 1/3-1/2 OF PATIENTS
Stereotaxic surgery?
TO ABOLISH AREAS OF BASAL GANGLIA TO REDUCE TREMOR AND RIGIDITY
*Used in early PD with L-dopa
*Most effective on tremors and rigidity?
ANTICHOLINERGICS
Dopamine agonist medications?
*ACT ON POST SYNAPTIC DOPAMINE RECEPTORS
*REDUCE RIGIDITY AND BRADYKINESIA
Side effects of Levodopa (L-dopa)?
GI, CONFUSION, HYPOTENSION, DYSURIA, SLEEP DISTURBANCES
Symptoms of PD?
*CIRCULATORY: VENOUS POOLING, LE EDEMA; ORTHOSTATIC HYPOTENSION IS COMMON (CAN BE WORSENED WITH L-DOPA
*NUTRITION: MALNOURISHMENT DUE TO SWALLOWING PROBLEMS, CONTRIBUTES TO FATIGUE
*DECUBITUS ULCERS
*SKIN: DERMATITIS FROM EXCESSIVE SWEATING AND OILY SKIN
The inital effects of L-dopa is sometimes referred to as what?
HONEYMOON PERIOD
True/False

It often takes L-dopa a long time to initially show it's positive effects?
FALSE

THE INITIAL FUNCTIONAL IMPROVEMENT IS OFTEN DRAMATIC
What is the primary benefit of L-dopa?
ALLEVIATING BRADYKINESIA AND RIGIDITY (WITH LESS EFFECT ON TREMORS)
Why is it necessary to give a pt high doses of L-dopa?
BECAUSE 99% OF IT IS METABOLIZED BEFORE IT REACHES THE BRAIN
A metabolic precursor of dopamine that is able to cross the blood-brain barrier and raise the level of striatal dopamine in the basal ganglia?
L-DOPS (LEVODOPA)
Bradyphrenia?
*A DISORDER OF INTELLECTUAL FUNCITON
*CHARACTERIZED BY A SLOWING OF THOUGHT AND INFORMATION PROCESSING
Why are there visual disturbances with PD?
BECAUSE OF COVENTIONAL DRUGS (IE: ANTICHOLINERGIC DRUGS)
What are the effects on the autonomic NS due to PD?
*EXCESSIVE PERSPIRATION
*DROOLING
*THERMOREGULATORY DIFFICULTY
*DECREASED GI TRACT MOTILITY
*ORTHOSTATIC HYPOTENSION
*LOW BP
Masklike face?
HYPOMIMIA
Gait disturbance?
*FESTINATING GAIT (SHORT STRIDE LENGTH WITH INCREASE IN SPEED); LACK OF EXTENSION OF LE; LACK OF TRUNK ROTATION; DIFFICULTY STARTING AND STOPPING
Micrographia?
SMALL HANDWRITING; DIFFICULT TO READ
Poor motor planning?
APRAXIA
Signs of resting tremors?
*INITIAL CLINICAL SIGN IN 70% OF PD
*RESTING TREMOR; PILL ROLLING TREMOR
*CAN BE SEEN IN FACE, FEET, LIPS, AND TONGUE
*LESS SEVERE WHEN PATIENT IS RELAXED, DIMINISHED BY VOLUNTARY EFFORT; DISAPPEARS DURING SLEEP
*WORSENED BY STRESS, FATIGUE, EXCITEMENT
*OFTEN FLUCTUATES IN INTENSITY AND FREQUENCY
Signs of bradykinesia?
*SLOWNESS OF MOVEMENT
*DIFFICULTY INITIATING MOTION; DECREASES IN SPEED, RANGE, AND AMPLITUDE OF VOLUNTARY AND AUTOMATIC MOVEMENT
*INCREASED RACTION TIME AND MOVEMENT TIME
*IMPAIRED COORDINATION, ESPECIALLY FINE MOTOR SKILLS
*SEVERE BRADYKINESIA=AKINESIA (FREEZING)
Sings and symptoms of rigidity in a PD pt?
*PATIENT C/O "HEAVINESS OR STIFFNESS"
*OCCURS IN AGONIST AND ANTAGONIST; CONSTANT REGARDLESS OF TAST, AMPLITUDE, SPEED OF MOTION
*MAY BE UNEQUAL IN DISTRIBUTION
*MAY BE EXTREMITY OR TRUNCAL; PROXIMAL AFFECTED FIRST
*INCREASED WITH FATIGUE, EMOTIONAL STRESS, OR MENTAL CONCENTRATION
*LEAD PIPE AND COGWHEEL
What are the cardinal signs of PD?
*BRR
*BRADYKINESIA
*RIGIDITY
*RESTING TREMOR
A decrease in dopamine and an increase in acetylcholine will result in what?
RESULTS IN EXCESSIVE EXCITATORY OUTPUT AND GENERALIZED ACTIVATION OF SKELETAL MUSCLE
True/False

Acetylcholine is inhibitory?
FALSE

EXCITITORY
True/False

Dopamine is inhibitory?
TRUE
What chemical is destroyed in the body due to PD?
DOPAMINE (NEUROTRANSMITTER)
Metabilic causes of PD?
DISORDERS OF CALCIUM METABOLISM MAY CAUSE CALCIFICATION OF THE BASAL GANGLIA (IE: HYPOTHYROIDISM, HYPOPARATHYROIDISM)
Late onset of idiopathic PD is what?
SPORADIC
Early onset of idiopathic PD is what?
FAMILIAL
Idiopathic PD?
*MOST COMMON FORM OF PD
*SLOWLY PROGRESSIVE WITH LONG SUBCLINICAL PERIOD; AVERAGE LIFE EXPECTANCY POST ONSET OF SYMPTOMS 13-14 YEARS.
*EARLY ONSET OFTEN FAMILIAL
*LATE ONSET OFTEN USUALLY SPORADIC
Caused by other NS diseases (supranuclear palsy, alzheimer's, creutzfield jacob dx)?
ATYPICAL PD
Caused by exposure to certain chemicals or industrial poisons?
TOXIC PARKINSON'S DISEASE
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