General practice & primary care · UKMLA & AKT
Parkinson's disease
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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