Karpatkin spring 4a

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Karpatkin spring 4a
2013-05-13 21:17:47
Karpatkin spring 2013

Karpatkin spring 2013
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  1. basic def of Parkinson's Disease (PD)
    idiopathic destruction of the substantia nigra
  2. Parkinsonism def
    PD type syndromes for non-idiopathic causes
  3. Parkinsons Plus syndromes
    classic features fo PD w additional non-PD symptoms

    are a group of neurodegenerative diseases featuring the classical features of Parkinson's disease (tremor, rigidity, akinesia/bradykinesia, postural instability) with additional features that distinguish them from simple idiopathic Parkinson's disease
  4. 4 examples of parkinsons plus syndromes
    • progressive supranuclear palsy
    • corticobasilar degeneration
    • multiple system atrophy
    • alzheimer's disease?
  5. how to diagnose PD
    • bradykinesia with atleast 2 of the following:
    • limb muslce rigidity, resting tremor (abolished with movement), postural instability
  6. in diagnosing PD, need to eliminate these secondary causes for PD symptoms
    • postencephaplitic parkinson's (a disease believed to be caused by a viral illness, that triggers degeneration of the nerve cells in the substantia nigra)
    • drug induced
    • toxic
    • stroke
    • trauma
    • neoplasm
    • other neurodegenerative conditions (Wilson's, Alzheimer's, Lewy Body dementia)
  7. the movement disorder PD affects _% of pop over 65 y/o, and it's the 2nd most common neurodegenerative disorder after__
    • 1-2%
    • Alzheimer's
  8. PD is due to an imbalance of __ and __ hormones
    dopamine and acetylcholine
  9. in PD there's a loss of __% of __ porduction in the __
    • 80-90
    • dopaminergic
    • substantia nigra
  10. Lewy Bodies
    abnormal aggregates of protein that develop inside nerve cells in Parkinson's disease
  11. most important risk factor for PD?
  12. risk factors for PD
    • age
    • fam history
    • male
    • environmental exposure to herbicides and pesticides, metals, well water, farming, rural residence, wood pulp mills, steel alloy industries
    • race (it's worse to be white)
    • life experiences (trauma, stress -- shyness&depression?)
  13. there's an inverse correlation btwn PD and what 2 habits?
    smoking & coffee
  14. methyl-phenyl tetrahydropyridine does what?
    destroyes substantia nigra
  15. what's the genetic predisposition for PD?
    • mutations n the gene for the protein alpha-synuclein
    • located on chromosome 4
  16. 4 theories on pathogenesis of PD
    • oxidative damage --> impaired protection
    • env toxins
    • genetic predisposition
    • advanced aging
  17. major neuropathologic findings in PD?
    • loss of pigmented dopaminergic neurons in the substantia nigra (60-80% are lost before motor signs of PD emerge)
    • synuclein-filled Lewy bodies within pigmented neurons of substantia nigra
  18. Lewy body pathology (appearing early in PD) begin where? this is associated with what? (ie, what are early signs of PD?)
    • olfactory bulb and lower brain stem
    • loss of sense of smell, and REM seep behavior disorder