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what is parkinsonism
condition that causes any of the abnormal movements seen in Parkinson's disease caused by the loss of dopamine containing cells
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what are four characteristics of parkinsonism
- tremors
- slow movement
- impaired speech – sounds like a whisper
- stiffness
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Parkinson's disease was originally called
shaking palsy
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who was the first person described Parkinson's disease
English physician James Parkinson
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true or false – Parkinson's disease is an acute neurological condition
false – is a chronic degenerative neurological condition
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what key neurotransmitter is deficient in Parkinson's disease
dopamine
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where is dopamine produced
substantia nigra
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true or false – (Parkinson's) approximately 80% of dopamine producing cells have died prior to symptoms onset
true
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when is onset for Parkinson's disease
50 – 65 years of age
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is Parkinson's disease more common in men or women
men = women
Some reports say higher incidence in men
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how many people out of 100,000 will suffer from Parkinson's disease
19
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what is the cause of Parkinson's disease
- definite cause unknown
- likely genetic or environmental
- industrial toxins
- drugs
- combination of genetic and environmental is commonly proposed cause
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what are the cardinal signs of Parkinson's disease
Four signs
- muscular rigidity
- resting tremor
- bradykinesia
- balance deficit
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what are signs and symptoms of Parkinson's disease
- shuffling gait pattern
- drooping posture
- masklike facial expression
- freezing during movement – doorways, elevators
- constipation
- impaired speech
- swallowing difficulty – big risk of choking and also a very early sign (drooling)
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true or false – patients normally have a resting tremor, but if they go to grab something the tremor will go away
true
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what are some psychiatric and behavioral symptoms of Parkinson's disease
- depression
- anxiety
- decreased motivation
- dementia, especially in later stages
- fatigue
- hallucinations
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what is a specific lab test for Parkinson's disease
there is no specific test
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how is Parkinson's disease diagnosed
diagnosis is a result of thorough medical history and clinical presentation
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how many cardinal signs must a patient demonstrate to be diagnosed with Parkinson's disease
two Cardinal signs and symptoms
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does parkinson's disease have a high rate of misdiagnosis
yes
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what are some differential diagnosis for Parkinson's disease
- parkinsonism– often medicine induced
- Huntington disease
- Lewy body dementia
- depression
- essential tremor
- TLA
- Alzheimer's disease
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what is the average lifespan after diagnosis
13 years
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true or false – the disease will get progressively better
false
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what is usually the cause of death for a patient with Parkinson's disease
- heart disease or infection,
- pneumonia
- choking– choking, lack of strength
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what are some complications of Parkinson's disease
- pressure ulcer
- joint contractures
- B&B trouble
- deep vein thrombosis
- fall risk
- dementia
- pneumonia
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describe the Parkinson's shuffle
- flexed posture – head and trunk
- shuffling feet
- absent or decrease arm swing
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true or false – levodopa is converted to enzymes in the brain to produce dopamine
true
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as Parkinson's disease progresses medication must also
progressively increase
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what is deep brain stimulation
- neurostimulator implanted to block abnormals nerve signal
- goal is to reduce on/off fluctuations and dyskinesia by targeting globus pallidusspace or subthalamic nuclei
- not recommended for patients with dementia
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who qualifies for deep brain stimulation
- Patients who respond to levodopa meds
- have idiopathic PD
- motor symptoms controlled by meds
No patients with dementia
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medication decreases by______% after deep brain stimulation units have been inserted
50%
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dyskinesia is reduced by_____% in patients who have had a deep brain stimulator placed
30
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motor scores increase by_____% in patients who have had the deep brain stimulator surgery
60%
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what is a physical therapy treatment for Parkinson's disease
- gait training
- balance
- coordination
- endurance
- strength
- range of motion/strengthening
- education
- assistive devices
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what are some ways that you can help the patient with Parkinson's disease walk better
- put tape on the floor
- clap hands
- music
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true or false – a physical therapist should be very exaggerated and loud when treating a patient with Parkinson's disease
true
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what are some good outcome measures used for Parkinson's disease
- Berg
- Tinetti
- get up and go
- dynamic gait index
Always do outcome measures to look at objective functional improvements
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