What are the 'Cardinal features' of Parkinson's Disease?
(Postural Instability doesn't occur until later in Parkinson's Disease)
What are the characteristics of a 'tremor' specific to Parkinson's Disease?
(anxiety, emotional excitement, & stress may exacerbate tremor)
How does a 'tremor' associated with Parkinson's Disease typically start?
(Presenting symptom in 70% of Parkinson's Disease Patients)
The most common & major cause of disability in Parksinon's Disease patients. Generalized slowness of movement.
(Patient Describers='Weakness, Incoordination, Tiredness')
The Speed, Amplitude, and Rhythm of what physical exam components should be carefully observed in evaluation of Bradykinesia in Parkinson's Disease patients?
What are common complaints from patients due to Bradykinesia?
Increased resistance to passive movement about a joint that occurs in 90% of Parkinson's Disease patients.
(Often starts unilaterally like Tremor & Bradykinesia)
Type of Rigidity that is a 'ratchet pattern of resistance & relaxation due to Tremor superimposed on increased tone'
Type of Rigidity that is a 'tonic resistance that is smooth throughout the entire range of passive movement'
How is Rigidity of a Parkinson's Disease patient tested at the bedside?
Those who have 'Postural Instability' early on in disease progression likely have a Parkinsonian Syndrome such as:
(Postural Instability onset is late in Classical Parkinson's Disease)
How is 'Postural Instability' evaluated?
(Tests fall risk)
What feature of Parkinson's Disease is the least responsive to Dopaminergic Therapy?
This type of Dementia is associated with Parkinson's Disease leading to: psychomotor retardation, memory difficulty, & altered personality.
What is earliest indicator of Subcortical Dementia onset in Parkinson's Disease?
(decision making & multi-tasking)
Patients with 'Parkinson's Disease + Subcortical Dementia' have this histological finding:
If a patient develops Dementia at least a year after the onset of Parkinsonian Motor System symptoms what is the Dx?
(Dementia with Lewy Bodies OR Parkinson's Disease Dementia
If Dementia begins before or concurrently with Parkinsonian Motor System symptoms, what is the Dx?
(Dementia with Lewy Bodies OR Parkinson's Disease Dementia
This type of testing is 'almost always UNHELPFUL in the evaluation of suspected Parkinson's Disease'
(MRI, US of brain, PET with FDG, Autonomic Testing)
Why should 'conventional MRI' be used in Parkinson's Disease patients?
(usually non diagnostic)
What can 'FDG PET' be used for in Parkinson's Disease patients?
Early falls (postural instability), poor response to L-DOPA, symmetry at onset, Rapid progression, Lack of Tremor, Dyautonomia are indicators for:
(Parkinsonism or Parkinson's Disease)
This may alleviate secondary othropedic effects of Rigidity and improve function in some motor tasks for Parkinson's Disease patients.
(Brisk walks, tai chi, swimming, Refer to physical therapist)
Possible way to improve speech volume in Parkinson's Disease patients
(Dysarthria & hypophonia)
Pharmacologic treatments are divided into these 2 groups for Parkinson's Disease patients:
The 'Symptomatic Pharmacologic Tx's' for Parkinson's Disease are:
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