Mer Scott
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PHCY320 (Neurology) Quiz sobre NE4 Parkinson's disease, criado por Mer Scott em 10-10-2019.

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NE4 Parkinson's disease

Questão 1 de 8

1

Epidemiology of PD:
- year mean age of onset
- 50% more likely to affect
- 90% , 10% hereditary

Primary motor symptoms:
- affects 70%
- (slow movement) affects everyone
- affects 90%

Psychiatric disturbances post diagnosis.
Dementia affects % of patients after diagnosis.

Arraste e solte para completar o texto.

    65
    men
    idopathic
    Tremor
    Bradykinesia
    Rigidity
    5-10 years
    20 years
    80

Explicação

Questão 2 de 8

1

Former smokers have 20% decreased risk of getting PD while current smokers have a 50% decreased risk.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 3 de 8

1

Reminder: The basal ganglia. matter structures - . Connections to , subthalamic nuclei, substantia nigra. Important in coordinating motor function.

Neurochemistry of PD: Dopamine (DA) deficient because of a greater than % loss of DA neurons in , and degeneration of in the striatum. bodies cause functional changes.

Arraste e solte para completar o texto.

    Grey
    striatum, globus pallidus
    thalamus
    50
    substantia nigra
    terminals
    Lewy

Explicação

Questão 4 de 8

1

Basal ganglia-thalamo-cortical loop is the in the brain where choices about planned movements are made. 4 linked parts: motor cortex, striatum, basal ganglia, thalamus.
The motor sends information about all planned movement to the . The signals then move to the , and then to the completing the selection process. The signals contain information about which moves to make and which moves to block.

Arraste e solte para completar o texto.

    motor loop
    cortex
    striatum
    basal ganglia
    thalamus

Explicação

Questão 5 de 8

1

Degeneration of dopaminergic neurons in the results in reduced stimulation of receptors in the striatum.
The consequence is overactive inhibition of the thalamus, and reduced excitation/activation of cortical systems. At the same time, in the glutamate pathways that connect the cortex to the reinforce the influence that basal ganglia has on movement.
The symptom most clearly related to this dopamine deficiency is hypokinesia.
Rigidity and tremor more complex and involve disturbances in and GABA.

> what ?
- old dopamine neurons not making enough dopamine = too much gaba going to thalamus. not enough glutamate going to cortex and too much glutamate coming from it = no movey movey

Arraste e solte para completar o texto.

    substantia nigra
    D1 and D2
    GABA
    glutamate
    hyperactivity
    striatum
    inhibitory
    Ach, NA, 5HT

Explicação

Questão 6 de 8

1

Drug that enhance dopaminergic activity
1. Levodopa
• Dopamine (DA cannot cross BBB)
• Extensive (periphery)
• SEs: nausea, vomiting,
• 1% oral dose reaches brain
• t1/2 (1h)
Modified release preps: more continuous supply
.. so we add DDC inhibitors e.g. carbedopa, benserazide. DCC inhibitors peripheral conversion:
- decreases L-dopa required
- decreases effects
Carbidopa + levodopa =
Benserazide + levodopa = Madopar
.. can also add inhibitors e.g. entacapone, tolcapone
• Prevent breakdown in periphery/CNS (30%)
half life

Arraste e solte para completar o texto.

    precursor
    decarboxylation
    arrhythmias, vasodilation
    short
    prevent
    dose
    side
    Sinemet
    COMT
    Double

Explicação

Questão 7 de 8

1

Usually around 3-4 hours after a dose of levodopa, the medication off and symptoms re-emerge or worsen. Symptoms then typically improve 15-45 after the next dose is taken. This phenomenon is called ‘wearing off’.

Motor fluctuations (e.g. phenomenon) are the changes in motor performance associated generally with taking levodopa but also with dopamine agonists in some cases. It is caused by a loss of DA producing cells over time. This means that the level of dopamine in your brain is increasingly dependent on the availability of levodopa in the , which in turn relies on your most recent dose of medication. ‘On’ time is when levodopa is well and symptoms are controlled. ‘Off’ time is when levodopa is no longer working well and symptoms such as movement re-emerge. As PD progresses they become less dose- related.

Arraste e solte para completar o texto.

    wears
    minutes
    on/off
    gradual
    blood
    working
    tremor, rigidity and slow
    timing

Explicação

Questão 8 de 8

1

DA agonists - derivatives: e.g. Bromocriptine, cabergoline, (pergolide*)
L-DOPA adjunct:
• Dose reduction
• Exacerbates L-DOPA motor

Monotherapy:
Longer , delay L-DOPA (L-DOPA sparing)
• increases SEs especially
• N&V, orthostatic hypotension,
• Serious fibrosis

Arraste e solte para completar o texto.

    Ergot
    complications
    t1/2
    psychiatric
    pulmonary, peritoneal and pericardial

Explicação