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26 Cards in this Set
- Front
- Back
4 Cardinal Features of Idiopathic Parkinsons
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tremor, rigidity, bradykinesia, postural instability
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5 Parkinsonian Syndromes
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Progressive Supranuclear Palsy
Corticobasal Ganglionic Degeneration Diffuse Lewy Body Disease Vascular Parkinsonism Multiple Systems Atrophy |
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Supranuclear opthalmoplegia, with limitation of vertical more than horizontal gaze; axial rigidity and neck extension early falls as a consequence of imparied postural reflexes, neck extension, and inability to look down
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Progessive Supranuclear Palsy
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Apraxia, cortical sensory impairment and alien-limb phenomenon; severe unilateral rigidity; stimulus-sensative myoclonus
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Corticobasal Ganglionic Degeneration
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Early dementia
Prominant visual hallucinations Extreme sensativity to extrapyramidal side-effects of antidopaminergic neuroleptic drugs |
Diffuse Lewy Body Disease
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"Lower-half" parkinsonism with rigidity in legs and marked gait impairment; other evidence of diffuse vascular disease (corticospinal tract dysfunction, pseudobulbar palsy)
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Vascular Parkinsonism
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Early and prominent features of autonomic dysfunction
Evidence of corticospinal tract dysfunction Cerebellar signs Stimulus-sensative myoclonus Vocal cord paresis |
Multiple systems atrophy
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The tremor in Idiopathic Parkinsons is fast/slow?
and more prominant when limb is at rest/in motion? |
slow
worst when limb is at rest |
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Dementia or delerium is seen in Parkinsons?
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Dementia in 1/3 of pts
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What is the name of L-Dopa + Carbidopa?
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Sinemet. Carbidopa inhibits peripheral decarboxylase (preventing dopamine formation outside the CNS)
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What is selegeline?
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monoamine oxidase B inhibitor
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Muscular rigidity, fever, autonomic lability, altered level of consciousness, elevated creatine kinase level, leukocytosis
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Neuroleptic Malignant Syndrome (NMS) <-- drugs with dopamine receptor-blocking activity
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Neuroleptic Malignant Syndrome (NMS)
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Muscular rigidity, fever, autonomic lability, altered level of consciousness, elevated creatine kinase level, leukocytosis <-- drugs with dopamine receptor-blocking activity (neuroleptics)
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What is Akathisia?
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an dysphoric state characterized by the subjective desire to be in constant motion <-- drugs with dopamine receptor-blocking activity
Anticholinergics and Beta blockers can be used to treat this |
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symptoms of Tardive Dyskinesia
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Orolinguomasticatory dyskenisia <-- drugs with dopamine receptor-blocking activity (neuroleptics)
Sx: chewing movements, lip smacking, rolling of the tongue inside the cheek. Tx: discontinue affecting agent. Dopamine depleting agents (reserpine, tetrabenzine) may help |
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Name 2 anticholinergics for Parkinsons Tx
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Trihexyphenidyl
Benztropin (Michael J Fox driving a Benz) Side Effects: Dry mouth, constipation, urinary retention, confusion, hallucination, narrow-angle glaucoma |
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Name an NMDA antagonist for Parkinsons Tx
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Amantadine
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Name 4 Dopamine agonists for Parkinsons Tx
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Bromocriptine
Pergolide Pramipexole Ripinirole Side effects: Nausea, orthostatic hypotension, psychosis, hallucinations, dyskinesia (Same as Levodopa/Carbidopa) |
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Name 2 COMT inhibitors for Parkinsons Tx
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Tolcapone
Entacapone similar side effects to levodopa/carbidopa and dopamine agonists. Nausea, orthostatic hypotension, confusion, dyskinesia |
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Mechanism of levodopa/carbidopa
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Dopamine precursor/dopa decarboxylase inhibitor
Side effects: anorexia, nausea, psychosis, hallucinations, orthostatic hypotension, dyskinesia |
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chonic axial muscle rigidity and stiffness and painful muscle spasms
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Stiff-person syndrome
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What antibody is associated with Stiff-person syndrome?
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Anti-GAD antibodies
"chonic axial muscle rigidity and stiffness and painful muscle spasms" |
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Causes of resting tremor
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Parkinson's Disease
Parkinsonian Syndromes |
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Causes of postural tremor
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(emerges during sustained maintenance of posture)
Essential Tremor Physiologic tremor Drugs (eg. theophylline, beta-agonists) Alcohol |
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Causes of action tremor
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Cerebellum and cerebellar outflow tract dysfunction (e.g. infarction, multiple sclerosis, tumor, Wilson's disease, drugs)
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what is intention tremor?
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a tremor that increases as the target is approached
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