quiz #1 – Parkinson's disease and parkinsonism

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quiz #1 – Parkinson's disease and parkinsonism
2011-02-20 22:26:31
clinical neurology

Parkinson's disease
Show Answers:

  1. what is parkinsonism
    condition that causes any of the abnormal movements seen in Parkinson's disease caused by the loss of dopamine containing cells
  2. what are four characteristics of parkinsonism
    • tremors
    • slow movement
    • impaired speech – sounds like a whisper
    • stiffness
  3. Parkinson's disease was originally called
    shaking palsy
  4. who was the first person described Parkinson's disease
    English physician James Parkinson
  5. true or false – Parkinson's disease is an acute neurological condition
    false – is a chronic degenerative neurological condition
  6. what key neurotransmitter is deficient in Parkinson's disease
  7. where is dopamine produced
    substantia nigra
  8. true or false – (Parkinson's) approximately 80% of dopamine producing cells have died prior to symptoms onset
  9. when is onset for Parkinson's disease
    50 – 65 years of age
  10. is Parkinson's disease more common in men or women
    men = women

    Some reports say higher incidence in men
  11. how many people out of 100,000 will suffer from Parkinson's disease
  12. what is the cause of Parkinson's disease
    • definite cause unknown
    • likely genetic or environmental
    • industrial toxins
    • drugs
    • combination of genetic and environmental is commonly proposed cause
  13. what are the cardinal signs of Parkinson's disease

    Four signs
    • muscular rigidity
    • resting tremor
    • bradykinesia
    • balance deficit
  14. what are signs and symptoms of Parkinson's disease
    • shuffling gait pattern
    • drooping posture
    • masklike facial expression
    • freezing during movement – doorways, elevators
    • constipation
    • impaired speech
    • swallowing difficulty – big risk of choking and also a very early sign (drooling)
  15. true or false – patients normally have a resting tremor, but if they go to grab something the tremor will go away
  16. what are some psychiatric and behavioral symptoms of Parkinson's disease
    • depression
    • anxiety
    • decreased motivation
    • dementia, especially in later stages
    • fatigue
    • hallucinations
  17. what is a specific lab test for Parkinson's disease
    there is no specific test
  18. how is Parkinson's disease diagnosed
    diagnosis is a result of thorough medical history and clinical presentation
  19. how many cardinal signs must a patient demonstrate to be diagnosed with Parkinson's disease
    two Cardinal signs and symptoms
  20. does parkinson's disease have a high rate of misdiagnosis
  21. what are some differential diagnosis for Parkinson's disease
    • parkinsonism– often medicine induced
    • Huntington disease
    • Lewy body dementia
    • depression
    • essential tremor
    • TLA
    • Alzheimer's disease
  22. what is the average lifespan after diagnosis
    13 years
  23. true or false – the disease will get progressively better
  24. what is usually the cause of death for a patient with Parkinson's disease
    • heart disease or infection,
    • pneumonia
    • choking– choking, lack of strength
  25. what are some complications of Parkinson's disease
    • pressure ulcer
    • joint contractures
    • B&B trouble
    • deep vein thrombosis
    • fall risk
    • dementia
    • pneumonia
  26. describe the Parkinson's shuffle
    • flexed posture – head and trunk
    • shuffling feet
    • absent or decrease arm swing
  27. true or false – levodopa is converted to enzymes in the brain to produce dopamine
  28. as Parkinson's disease progresses medication must also
    progressively increase
  29. what is deep brain stimulation
    • neurostimulator implanted to block abnormals nerve signal
    • goal is to reduce on/off fluctuations and dyskinesia by targeting globus pallidusspace or subthalamic nuclei
    • not recommended for patients with dementia
  30. who qualifies for deep brain stimulation
    • Patients who respond to levodopa meds
    • have idiopathic PD
    • motor symptoms controlled by meds

    No patients with dementia
  31. medication decreases by______% after deep brain stimulation units have been inserted
  32. dyskinesia is reduced by_____% in patients who have had a deep brain stimulator placed
  33. motor scores increase by_____% in patients who have had the deep brain stimulator surgery
  34. what is a physical therapy treatment for Parkinson's disease
    • gait training
    • balance
    • coordination
    • endurance
    • strength
    • range of motion/strengthening
    • education
    • assistive devices
  35. what are some ways that you can help the patient with Parkinson's disease walk better
    • put tape on the floor
    • clap hands
    • music
  36. true or false – a physical therapist should be very exaggerated and loud when treating a patient with Parkinson's disease
  37. what are some good outcome measures used for Parkinson's disease
    • Berg
    • Tinetti
    • get up and go
    • dynamic gait index

    Always do outcome measures to look at objective functional improvements