Question 1

A patient diagnosed with Parkinson's disease (PD) has been prescribed carbidopa-levodopa with good results but develops increased dyskinesia. Which drug will be added to this patient's regimen to help control this symptom?

A) Amantadine
B) Benztropine
C) Ropinirole
D) Tolcapone

A

Accepted Answer

Amantadine is a drug that can be added to the regimen of patients with PD who have developed dyskinesia from levodopa therapy. It is thought to work by increasing dopamine release and reducing the activity of the overactive glutamatergic pathways in the basal ganglia. Benztropine is a drug used for tremors and stiffness, and may worsen dyskinesia. Ropinirole is a dopamine agonist used in early PD, not for dyskinesia management. Tolcapone is a COMT inhibitor, which may prolong the action of levodopa but isn't used for dyskinesia control.

Question 2

A primary care provider suspects Parkinson's disease (PD) in a patient. Which tests may be performed to diagnose this disorder?&#10;A) Neuroimaging to identify specific midbrain lesion&#10;B) Neuromuscular studies to identify reflex function&#10;C) Presence of 2 cardinal signs which improve with levodopa&#10;D) Serum creatine phosphokinase levels

Accepted Answer

The diagnosis of PD is primarily clinical, based on the presence of at least two cardinal signs (resting tremor, bradykinesia, rigidity, and postural instability) that respond to levodopa. Neuroimaging can be used to support the diagnosis, but is not necessary for diagnosis. Neuromuscular studies and serum creatine phosphokinase levels are not useful in the diagnosis of PD.

Question 3

What are common symptoms noted in patients diagnosed with Parkinson's disease? (Select all that apply.)&#10;A) Bradykinesia&#10;B) Festination&#10;C) Hyperphonia&#10;D) Rigidity&#10;E) Symmetric tremor

Accepted Answer

Bradykinesia, festination, and rigidity are common symptoms of Parkinson's disease. Bradykinesia refers to slowness of movement, festination is a rapid, shuffling gait, and rigidity is muscle stiffness. Hyperphonia and symmetric tremor are not typical symptoms; Parkinson's tremor is usually asymmetric.

Deck 181: Parkinsons Disease