Neuro Week 6 Test

Front

What are the hallmark motor symptoms of Parkinson’s Disease (PD)? Options: Muscle weakness, spasticity, sensory loss, fatigue; Bradykinesia, rigidity, resting tremor, postural instability; Intention tremor, hypotonia, fatigue, clonus; Akinesia, hyperreflexia, muscle wasting, fasciculations

Back

Bradykinesia, rigidity, resting tremor, postural instability

Answer explanation

💡 Bradykinesia (slowness of movement), rigidity (increased muscle tone and resistance to passive movement), resting tremor (involuntary shaking when the muscles are at rest), and postural instability (impaired balance leading to increased fall risk) are the four hallmark motor signs of PD. A clinical diagnosis typically requires at least two of these, with bradykinesia being essential. These symptoms result from dopamine depletion affecting the basal ganglia’s ability to regulate motor programs.

Front

Which brain structure degenerates in Parkinson’s Disease, causing dopamine depletion? Options: Thalamus, Cerebellum, Substantia nigra, Red nucleus

Back

Substantia nigra

Answer explanation

💡 Parkinson’s Disease (PD) primarily affects a part of the brain called the substantia nigra pars compacta, which is responsible for producing dopamine (a chemical messenger that helps control smooth and automatic movement). The basal ganglia, which help coordinate and start movements, rely on dopamine to work properly. When these dopamine-producing cells die, the balance of movement signals is disrupted — this leads to hypokinetic symptoms (meaning reduced movement), such as bradykinesia (slowness), hypokinesia (small movement size), and rigidity (stiffness).

Front

What best explains "Freezing of Gait" in PD?

Back

A transient inability to initiate or continue movement due to impaired automatic motor control

Answer explanation

💡 Freezing of gait (FOG) is a sudden, brief episode where the person is unable to step despite intending to walk. It’s triggered by basal ganglia dysfunction and worsens with stress, turns, or dual-tasking. It's one of the most disabling features in moderate to advanced PD.

Front

Which non-motor symptom often precedes motor signs in PD?

Back

Anosmia

Answer explanation

💡 Anosmia, or loss of smell, can occur years before motor symptoms appear. It’s considered an early preclinical sign and reflects how PD pathology can start outside the motor system, possibly in the olfactory bulb and brainstem before progressing to the substantia nigra.

Front

What is the primary function of the basal ganglia in normal movement?

Back

Retrieves and executes automatic motor programs

Answer explanation

💡 The basal ganglia allow efficient execution of learned, habitual motor sequences — like walking or writing — without needing conscious attention. In PD, dopamine loss disrupts this automation, making movement effortful and attention-dependent.

Front

Why do people with PD struggle with dual-tasking, like walking and talking?

Back

They lose automatic movement control, so walking needs conscious attention.

Answer explanation

💡 In PD, movement becomes reliant on conscious control because the basal ganglia can no longer run automatic motor programs. This makes walking + talking simultaneously difficult, as attention gets split, often leading to freezing or instability.

Front

What is the difference between lead-pipe and cogwheel rigidity in PD?

Back

Lead-pipe is smooth resistance; cogwheel is jerky, ratchet-like resistance

Answer explanation

💡 Lead-pipe rigidity is a steady, constant resistance throughout the range of motion, while cogwheel rigidity adds a rhythmic “catching” sensation, often due to superimposed tremor. Both are types of increased muscle tone seen in PD and are non–velocity dependent.

Front

Which gait features are typical in Parkinson’s Disease? Options: Wide stance, hyperextension, and toe walking; Ataxic steps with high stepping; Spastic, scissoring gait; Shuffling steps, reduced arm swing, festination, and freezing

Back

Shuffling steps, reduced arm swing, festination, and freezing

Answer explanation

💡 Parkinsonian gait is characterized by slow, small, shuffling steps, a stooped posture, reduced arm swing, and festination (involuntary quickening of steps). Freezing episodes are common, especially when turning or passing through narrow spaces.

Front

What is a key fall risk predictor in Parkinson’s Disease? Options: Limb spasticity, Freezing of gait and gait speed <1.1 m/s, Presence of resting tremor, Use of walking aids

Back

Freezing of gait and gait speed <1.1 m/s

Answer explanation

💡 Fall risk is strongly associated with a history of falls, freezing of gait, and reduced gait speed. Gait speed less than 1.1 m/s is a validated predictor of falls, often used in assessments like the TUG or 10m Walk Test.

Front

Which statement is true about Levodopa use in PD? Options: It cures Parkinson’s Disease over time, It has no effect on bradykinesia, It improves symptoms but causes long-term complications like dyskinesias, It can be stopped abruptly without issue

Back

It improves symptoms but causes long-term complications like dyskinesias

Answer explanation

💡 Levodopa is the most effective drug for improving motor symptoms like bradykinesia and rigidity. However, long-term use often leads to motor complications such as dyskinesias (involuntary writhing movements) and on/off fluctuations in symptom control.