Parkinson's Disease 3 — Questions and Answers
Question 1: Which type of muscle rigidity is classically associated with Parkinson's disease?
- Spasticity (velocity-dependent rigidity)
- Cogwheel rigidity (Correct answer)
- Flaccid rigidity
- Clasp-knife rigidity
Correct answer: Cogwheel rigidity
Cogwheel rigidity—a ratchet-like resistance felt during passive movement of a limb—is the type of rigidity characteristic of Parkinson's disease.
Question 2: What does the term 'masklike facies' refer to in the context of Parkinson's disease?
- Facial pain due to nerve damage
- Reduced facial expression due to hypomimia (Correct answer)
- A skin rash associated with medication side effects
- Facial twitching caused by tremor
Correct answer: Reduced facial expression due to hypomimia
Masklike facies (hypomimia) describes the reduced facial expression seen in Parkinson's patients due to bradykinesia affecting facial muscles.
Question 3: Which non-motor symptom of Parkinson's disease often precedes motor symptoms by years?
- Dementia
- Rapid eye movement (REM) sleep behavior disorder (Correct answer)
- Hallucinations
- Orthostatic hypotension
Correct answer: Rapid eye movement (REM) sleep behavior disorder
REM sleep behavior disorder, where patients act out their dreams, can precede the motor symptoms of Parkinson's disease by 10 or more years.
Question 4: Loss of smell (anosmia) in Parkinson's disease is an example of which category of symptoms?
- Motor symptoms
- Non-motor symptoms (Correct answer)
- Iatrogenic symptoms
- Rebound symptoms
Correct answer: Non-motor symptoms
Anosmia (loss of smell) is a non-motor symptom that can appear early in Parkinson's disease, often before motor symptoms develop.
Question 5: What is the typical pattern of symptom onset in idiopathic Parkinson's disease?
- Sudden onset on both sides simultaneously
- Gradual onset, initially asymmetric (one-sided) (Correct answer)
- Relapsing-remitting episodes
- Rapid progression over weeks
Correct answer: Gradual onset, initially asymmetric (one-sided)
Idiopathic Parkinson's disease characteristically begins asymmetrically, with symptoms more pronounced on one side of the body, progressing gradually.
Question 6: Which of the following best describes 'postural instability' in Parkinson's disease?
- Difficulty maintaining an upright posture due to impaired balance reflexes (Correct answer)
- Involuntary bending of the spine
- Muscle weakness causing inability to stand
- Pain from spinal degeneration
Correct answer: Difficulty maintaining an upright posture due to impaired balance reflexes
Postural instability in Parkinson's results from impaired postural reflexes, increasing the risk of falls and is typically a later-stage symptom.
Question 7: Festination, a gait abnormality seen in Parkinson's disease, is best described as:
- A wide-based, staggering walk
- Involuntary acceleration with increasingly short, shuffling steps (Correct answer)
- Complete inability to initiate walking
- A high-stepping gait with foot slapping
Correct answer: Involuntary acceleration with increasingly short, shuffling steps
Festination refers to the involuntary tendency to take increasingly rapid, small shuffling steps, as if the patient is trying to catch up with their center of gravity.
Parkinson's Disease 3
Which type of muscle rigidity is classically associated with Parkinson's disease?