General practice & prim · UKMLA & AKT
Parkinson's disease
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise parkinson's disease — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Classic triad: bradykinesia + resting tremor + rigidity - onset is asymmetrical (unilateral first)
- Bradykinesia - slowness/difficulty initiating movement; cardinal feature required for diagnosis
- Resting tremor - 3-5 Hz 'pill-rolling'; present at rest, suppressed by intentional movement
- Rigidity - cogwheel rigidity (ratchet-like) on passive movement
- Gait - shuffling, small steps (festination), freezing of gait
- Other motor: hypomimia (masked facies), micrographia, hypophonia
- Non-motor (may precede motor symptoms): anosmia, REM sleep behaviour disorder, depression/anxiety, constipation, orthostatic hypotension, cognitive impairment
PD tremor is a RESTING tremor that IMPROVES with intentional movement. Essential tremor is an ACTION/POSTURAL tremor that WORSENS with movement - no bradykinesia or rigidity. Essential tremor is managed with propranolol.
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