Parkinson's Disease
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Questions and Answers

Which of the following is the most characteristic feature seen in the neurons of patients with Parkinson's disease?

  • Amyloid plaques
  • Lewy bodies (correct)
  • Tangles
  • Neurofibrillary tangles

    • At what age do symptoms of Parkinson's disease typically begin to manifest?

  • 40-45 years
  • 50-55 years
  • 55-60 years (correct)
  • 65-70 years

    • Which part of the brain is primarily affected in Parkinson's disease?

  • Cerebellum
  • Substantia nigra (correct)
  • Hippocampus
  • Medulla oblongata

    • Which of the following is the most common gender distribution for Parkinson's disease?

    <p>Males 1.5 times more likely than females</p> Signup and view all the answers

    What percentage of dopaminergic neurons are typically lost before motor signs of Parkinson's disease appear?

    <p>60-80%</p> Signup and view all the answers

    Which of the following stages of Parkinson's disease is most associated with the appearance of motor symptoms?

    <p>Stage 3</p> Signup and view all the answers

    Which of the following structures is NOT part of the basal ganglia?

    <p>Hippocampus</p> Signup and view all the answers

    The basal ganglia play a key role in the control of which of the following? A) Memory B) Voluntary movements and posture C) Vision D) Sensory processing

    <p>Voluntary movements and posture</p> Signup and view all the answers

    Which of the following occurs when the basal ganglia are altered, as in Parkinson's disease?

    <p>Unwanted movements</p> Signup and view all the answers

    The primary function of the basal ganglia is to help regulate which aspect of motor control?

    <p>Voluntary movements and postures</p> Signup and view all the answers

    Which of the following best describes the role of the basal ganglia in movement disorders like Parkinson's disease?

    <p>They are responsible for initiating and regulating voluntary movements.</p> Signup and view all the answers

    Where is the substantia nigra located in the brain?

    <p>In the midbrain</p> Signup and view all the answers

    Which neurotransmitter is produced by the cells of the substantia nigra?

    <p>Dopamine</p> Signup and view all the answers

    Which of the following structures does the substantia nigra project to?

    <p>Caudate and putamen</p> Signup and view all the answers

    What is the consequence of degeneration in the substantia nigra in Parkinson's disease?

    <p>Loss of melanin-containing cells and dopamine production</p> Signup and view all the answers

    What happens when there is an imbalance in the excitatory and inhibitory pathways regulating movement in Parkinson's disease?

    <p>Crippling motor symptoms such as tremors and rigidity</p> Signup and view all the answers

    Which of the following describes the function of the nigrostriatal pathway in normal motor function?

    <p>It modulates output from the motor cortex to regulate movement.</p> Signup and view all the answers

    Which neurotransmitter is primarily affected in Parkinson's Disease?

    <p>Dopamine</p> Signup and view all the answers

    Which of the following toxins is known to be associated with Parkinson’s disease?

    <p>Manganese</p> Signup and view all the answers

    Which of the following is a drug that can induce Parkinson's-like symptoms?

    <p>Antipsychotics</p> Signup and view all the answers

    Which of the following genetic mutations is associated with Parkinson’s disease?

    <p>Park-1</p> Signup and view all the answers

    What role do oxygen free radicals play in the development of Parkinson's disease?

    <p>They damage neurons and contribute to neurodegeneration.</p> Signup and view all the answers

    Which of the following accounts for less than 5% of Parkinson's disease cases?

    <p>Genetic factors</p> Signup and view all the answers

    Which of the following is NOT one of the cardinal motor symptoms of Parkinson’s disease?

    <p>Memory loss</p> Signup and view all the answers

    Which type of tremor is most commonly seen in Parkinson's disease?

    <p>Pill rolling tremor</p> Signup and view all the answers

    Which of the following is a characteristic of the tremor seen in Parkinson's disease?

    <p>Unilateral and rapid at rest</p> Signup and view all the answers

    Which of the following is most associated with bradykinesia in Parkinson’s disease?

    <p>Difficulty initiating and performing voluntary movements</p> Signup and view all the answers

    Which of the following is a feature of bradykinesia?

    <p>Decreased amplitude of movement during writing</p> Signup and view all the answers

    Which of the following can exacerbate tremor in Parkinson’s disease? A) Rest B) Relaxation C) Stress D) Deep breathing

    <p>Stress</p> Signup and view all the answers

    Rapid fatigability of repetitive movements is a common feature of which symptom in Parkinson’s disease?

    <p>Bradykinesia</p> Signup and view all the answers

    What is a common characteristic of rigidity in Parkinson's disease?

    <p>Increased resistance to passive stretch</p> Signup and view all the answers

    Which of the following is a type of rigidity commonly seen in Parkinson’s disease?

    <p>Lead pipe rigidity</p> Signup and view all the answers

    Postural instability in Parkinson's disease typically contributes to which of the following?

    <p>High risk of falls due to poor balance</p> Signup and view all the answers

    Which gait feature is most associated with Parkinson's disease?

    <p>Shuffling gait with poor arm swing</p> Signup and view all the answers

    Which of the following is a common non-motor symptom of Parkinson's disease?

    <p>Depression and sleep disturbances</p> Signup and view all the answers

    Which of the following is commonly associated with sleep disturbances in Parkinson’s disease?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a non-motor symptom of Parkinson's disease related to cognition?

    <p>Executive dysfunction and dementia</p> Signup and view all the answers

    Which of the following autonomic symptoms is commonly seen in Parkinson’s disease?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    Which of the following is a common feature of motor symptoms in Parkinson’s disease?

    <p>Freezing during movement and festination</p> Signup and view all the answers

    Which of the following facial features is characteristic of Parkinson’s disease?

    <p>Hypomimia (masked facies)</p> Signup and view all the answers

    Which of the following non-motor symptoms in Parkinson's disease is associated with sensory changes?

    <p>Anosmia (loss of smell)</p> Signup and view all the answers

    Which of the following can occur in Parkinson’s disease due to autonomic dysfunction? (Select one)

    <p>Urinary incontinence</p> Signup and view all the answers

    Which of the following is a common gastrointestinal symptom in Parkinson’s disease?

    <p>Constipation</p> Signup and view all the answers

    Which of the following is a sensory symptom commonly seen in Parkinson’s disease?

    <p>Anosmia (loss of smell)</p> Signup and view all the answers

    In Parkinson’s disease, constipation is most often caused by:

    <p>Reduced gastrointestinal motility due to autonomic dysfunction</p> Signup and view all the answers

    Which sensory issue is commonly observed in Parkinson's disease? (Select one)

    <p>Impaired proprioception (difficulty sensing body position)</p> Signup and view all the answers

    Which of the following is a non-sensory symptom of Parkinson's disease?

    <p>Urinary incontinence</p> Signup and view all the answers

    Which of the following is the primary method for diagnosing Parkinson's disease?

    <p>History and neurological examination</p> Signup and view all the answers

    When assessing for Parkinson's disease, it is important to examine for signs of which of the following?

    <p>Cognitive impairment and cerebellar signs</p> Signup and view all the answers

    The presence of cognitive impairment in Parkinson's disease may suggest:

    <p>Parkinson's plus syndrome</p> Signup and view all the answers

    Which of the following is NOT typically associated with Parkinson's disease but may suggest Parkinson's plus syndrome?

    <p>Cognitive impairment</p> Signup and view all the answers

    When assessing rapid repetitive movements in Parkinson's disease, the physician may observe:

    <p>Difficulty performing fine motor tasks</p> Signup and view all the answers

    Lead pipe rigidity refers to:

    <p>Resistance to passive movement that is constant throughout</p> Signup and view all the answers

    Cog-wheel rigidity is characterized by:

    <p>A jerky, ratcheting motion during passive movement</p> Signup and view all the answers

    Postural instability in Parkinson's disease is most likely to result in:

    <p>Difficulty maintaining balance while standing or walking</p> Signup and view all the answers

    Which of the following is a clinical sign that would suggest Parkinson's plus syndrome rather than typical Parkinson's disease?

    <p>Cerebellar signs (e.g., ataxia)</p> Signup and view all the answers

    Which of the following is the most common differential diagnosis for Parkinson's disease due to its similar tremor characteristics?

    <p>Essential tremor</p> Signup and view all the answers

    Which of the following is NOT commonly associated with Parkinson’s disease but should be considered in the differential diagnosis of parkinsonism?

    <p>Thyrotoxicosis</p> Signup and view all the answers

    Drug-induced parkinsonism can be caused by which of the following classes of medications?

    <p>Antipsychotics</p> Signup and view all the answers

    In which condition is Parkinsonism less responsive to typical Parkinson’s medications like levodopa?

    <p>Parkinson's Plus syndromes</p> Signup and view all the answers

    Which of the following is the most common differential diagnosis for Parkinson's disease due to its similar tremor characteristics?

    <p>Essential tremor</p> Signup and view all the answers

    Drug-induced parkinsonism can be caused by which of the following classes of medications?

    <p>Antipsychotics</p> Signup and view all the answers

    In which condition is Parkinsonism less responsive to typical Parkinson’s medications like levodopa?

    <p>Parkinson's Plus syndromes</p> Signup and view all the answers

    Which of the following conditions is least likely to be confused with Parkinson’s disease but is included in the differential diagnosis of parkinsonism?

    <p>Thyrotoxicosis</p> Signup and view all the answers

    Which of the following features is characteristic of Parkinson's Plus syndromes?

    <p>Early postural instability and dementia</p> Signup and view all the answers

    Which of the following signs is more commonly observed in Parkinson’s Plus syndromes than in typical Parkinson’s disease?

    <p>Axial involvement (e.g., postural instability)</p> Signup and view all the answers

    Which of the following features is most likely to differentiate Progressive Supranuclear Palsy (PSP) from typical Parkinson's disease?

    <p>Paralysis of upward gaze</p> Signup and view all the answers

    Which of the following is a hallmark sign of Multisystem Atrophy (MSA) that is not typically seen in idiopathic Parkinson's disease?

    <p>Postural instability and falls</p> Signup and view all the answers

    Which of the following is most commonly seen in Progressive Supranuclear Palsy (PSP)?

    <p>Personality changes</p> Signup and view all the answers

    Which of the following features is commonly seen in Parkinson's disease but is not characteristic of cerebellar diseases?

    <p>Bradykinesia</p> Signup and view all the answers

    Which of the following is the primary method for diagnosing Parkinson’s Disease?

    <p>Movement Disorder Society clinical diagnostic criteria</p> Signup and view all the answers

    Which of the following is the role of MRI in diagnosing Parkinson's Disease?

    <p>MRI is used to exclude other diseases that may mimic Parkinson's Disease.</p> Signup and view all the answers

    What is the main advantage of DaTscan in the diagnosis of Parkinson's Disease?

    <p>It can distinguish Parkinson's Disease from essential tremor (ET).</p> Signup and view all the answers

    Which of the following is NOT a primary aim of Parkinson’s Disease management?

    <p>Treat other neurological disorders</p> Signup and view all the answers

    Which of the following is NOT a non-pharmacological approach to managing Parkinson’s Disease?

    <p>Surgical interventions</p> Signup and view all the answers

    Which of the following statements is true regarding the use of DaTscan in Parkinson's Disease diagnosis?

    <p>DaTscan can help differentiate Parkinson's Disease from essential tremor but not from other parkinsonian syndromes.</p> Signup and view all the answers

    In managing Parkinson's Disease, which of the following is NOT typically considered in non-pharmacological treatment?

    <p>Antidepressant medications</p> Signup and view all the answers

    What is the primary goal of pharmacological treatment in Parkinson's Disease?

    <p>To replace dopamine deficiency and prevent dopamine breakdown</p> Signup and view all the answers

    Which of the following medications is most commonly used to replace dopamine in Parkinson's Disease treatment?

    <p>Levodopa</p> Signup and view all the answers

    Which of the following is used alongside levodopa to prevent its breakdown?

    <p>COMT inhibitors</p> Signup and view all the answers

    Which of the following medications is a dopamine agonist commonly used in the treatment of Parkinson's Disease?

    <p>Bromocriptine</p> Signup and view all the answers

    Why is levodopa often deferred in the initial stages of Parkinson's Disease treatment?

    <p>It has long-term side effects that may outweigh its benefits.</p> Signup and view all the answers

    Which of the following is the most effective initial treatment for Parkinson’s Disease in patients older than 70 years?

    <p>Levodopa combined with Dopa decarboxylase inhibitors</p> Signup and view all the answers

    What is the primary side effect concern associated with long-term use of levodopa in Parkinson's Disease treatment?

    <p>Dyskinesias (chorea or dystonia) and motor fluctuations (on-off phenomenon)</p> Signup and view all the answers

    How should levodopa be taken to achieve better absorption?

    <p>On an empty stomach, pre-meal</p> Signup and view all the answers

    Which of the following medications can be used to treat transient nausea when starting levodopa treatment?

    <p>Domperidone</p> Signup and view all the answers

    Which of the following medications is used as a COMT inhibitor in the management of Parkinson's Disease?

    <p>Entacapone</p> Signup and view all the answers

    Which of the following medications is used as a COMT inhibitor in the management of Parkinson's Disease?

    <p>Entacapone</p> Signup and view all the answers

    Which of the following is a MAO-B inhibitor used in the treatment of Parkinson's Disease?

    <p>Selegiline</p> Signup and view all the answers

    Which of the following medications is used as an anticholinergic for treating tremor and drooling in Parkinson's Disease?

    <p>Biperidine</p> Signup and view all the answers

    What is the primary function of MAOB inhibitors like Selegiline and Rasagiline in Parkinson's Disease treatment?

    <p>To inhibit the breakdown of dopamine</p> Signup and view all the answers

    Which medication class is used to reduce tremor and drooling in Parkinson's Disease?

    <p>Anticholinergics</p> Signup and view all the answers

    What is the "wearing off phenomenon" in Parkinson's Disease?

    <p>Reduced response to levodopa leading to motor fluctuations</p> Signup and view all the answers

    What is the recommended treatment for frequent 'wearing off' episodes between levodopa doses?

    <p>Add a COMT inhibitor</p> Signup and view all the answers

    Which intervention can be used to address freezing episodes in Parkinson's Disease?

    <p>Increase levodopa dose or frequency</p> Signup and view all the answers

    Which of the following is the role of COMT inhibitors in managing Parkinson's Disease?

    <p>Decrease the breakdown of dopamine, prolonging the effect of levodopa</p> Signup and view all the answers

    Which type of surgery was traditionally used to control Parkinson's Disease symptoms before levodopa became the main treatment?

    <p>Thalamotomy and Pallidotomy</p> Signup and view all the answers

    What does Deep Brain Stimulation (DBS) achieve in Parkinson's Disease treatment?

    <p>It stimulates the thalamus and globus pallidus to reset abnormal firing patterns</p> Signup and view all the answers

    Which of the following is a common target for deep brain stimulation in Parkinson's Disease?

    <p>Thalamus and globus pallidus</p> Signup and view all the answers

    What is the primary benefit of subthalamic deep brain stimulation in Parkinson’s Disease?

    <p>Reduces dyskinesias and decreases medication use</p> Signup and view all the answers

    Which of the following is a requirement for deep brain stimulation surgery in Parkinson's Disease?

    <p>Clear diagnosis of Parkinson's Disease with motor fluctuations</p> Signup and view all the answers

    What is the typical duration of improvement after deep brain stimulation surgery in Parkinson's Disease?

    <p>5 years</p> Signup and view all the answers

    Which of the following is NOT a typical symptom in the late stage of Parkinson's Disease?

    <p>Tremor improvement</p> Signup and view all the answers

    What is a key characteristic of the 'honeymoon period' in Parkinson's Disease?

    <p>Initial improvement in symptoms with treatment</p> Signup and view all the answers

    A 65-year-old male presents with tremor, bradykinesia, and rigidity. He has a history of difficulty with balance, frequent falls, and increasing difficulty with swallowing. His family reports that he has also developed significant cognitive impairment over the past year, including memory loss and difficulty with executive functions. On examination, he demonstrates a symmetrical tremor at rest, lead-pipe rigidity, and difficulty with upward gaze. Which of the following features in this patient is most likely indicative of a Parkinson's Plus Syndrome?

    <p>Difficulty with upward gaze</p> Signup and view all the answers

    What is the most likely explanation for the patient’s muscle stiffness and 'cogwheel' rigidity?

    <p>Parkinson’s Disease</p> Signup and view all the answers

    A 58-year-old female with a long history of Parkinson's Disease begins to complain of increased sweating, especially at night, and frequent episodes of dizziness upon standing. She also has problems with bowel movements and reports some difficulty with sense of smell. Neurological examination reveals tremor, bradykinesia, and postural instability. Which of the following non-motor symptoms is this patient experiencing that is commonly associated with Parkinson's Disease?

    <p>Anosmia (loss of smell)</p> Signup and view all the answers

    What is the most appropriate next step in management for a 68-year-old male with Parkinson's Disease experiencing increasing motor fluctuations and dyskinesia after 5 years on levodopa therapy?

    <p>Add a COMT inhibitor</p> Signup and view all the answers

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