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18 Cards in this Set
- Front
- Back
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What is the neurological cause of Huntington's Disease?
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Increased motor activity due to reduced inhibition of the ventral thalamus by the globus pallidus and substantia nigra.
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Briefly describe Wilson's Disease.
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Wilson's Disease: A disorder of copper metabolism producing neurological and hepatic dysfunction.
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Outline the pathology of Multiple Sclerosis.
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- Autoimmune
- Demyelination of CNS - CNS plaques (sclerosis) |
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Describe the pathology encountered in Alzheimer's Disease.
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- Cortical atrophy
- Decreased brain weight - Ventricle enlargement - Amyloid plaques - Neurofibrillary tangles |
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What is the neurological cause of Parkinson's Disease?
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- Pallor (loss of pigmentation) of the substantia nigra and locus ceruleus.
- Lewy bodies |
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What are the risk factors for Alzheimer's Disease?
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- Advancing age
- Genetics: (Apolipoprotein e4, Presenilin PS1/PS2) - Head injury - Low education |
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What are the risk factors for Parkinson's Disease?
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- Advancing age
- Exposure to pesticides - Neurological infection - Genetics (PARK1, PARK2, PARK5) |
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List four (4) main clinical features of Parkinson's Disease?
How many of these symptoms need to be present to make a diagnosis? |
1. Resting Tremor
2. Cogwheel/Leadpipe Rigidity 3. Akinesia 4. Postural instability Need to have at least 2 of these symptoms. |
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List four (4) minor additional clinical features of Parkinson's Disease.
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1. Dysphagia
2. Shuffling gait 3. Micrographia (small writing) 4. Dementia |
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List three (3) differentials for Parkinsonian syndrome.
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1. Vascular Parkinsonism
2. Progressive Supranuclear Palsy 3. Multiple System Atrophy |
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What neuronal pathway are altered to elicit Parkinson's symptoms?
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- Loss of dopaminergic neurones
- Inhibition of direct pathway - Excitation of indirect pathway THEREFORE - Increased suppression of movement - Decreased initiation of movement |
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What mechanism accounts for the tremors seen in Parkinson's?
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- Overactivity of cholinergic pathways
- Loss of dopaminergic control of basal ganglia |
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List three dopamine agonists effective in the management of Parkinson's.
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1. Apomorphine
2. Bromocriptine 3. Pergolide |
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List four (4) classes of drugs that are effective in the management of Parkinson's.
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1. Dopamine (Levodopa)
2. Dopamine agonists 3. COMT inhibitors 4. MAOIs |
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Why is levodopa a more effective treatment than pure dopamine itself?
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Levodopa crosses the BBB to act on the neurones, whereas dopamine just stays in the bloodstream.
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When would you start administering drug therapy in a patient diagnosed with Parkinson's?
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Not immediately. If symptoms are mild best to wait due to side-effects (dyskinesia, nausea). Otherwise start with low doses.
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Why is levodopa not 'disease-protective' (i.e. not curative) of patients with advanced Parkinson's?
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Because patients with advanced Parkinson's have already lost ~70% of their SN neurones are therefore the disease will progress despite treatment.
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Name two alternative (non-drug) therapies for Parkinsons.
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- Ablation (thalamotomy, pallidotomy)
- Deep brain stimulation |
