Physician Focus on Parkinson's
Issue 17 (Spring 2011) - Quarterly CME Newsletter on Parkinson's Disease
To receive CME credit for this activity, please complete the post-test and evaluation by clicking "Continue" below. Once submitted, a certificate will be issued within two weeks to the email address provided.
Click here to view Issue 17 online. You may also view the Patient Education Tool online here. This issue discusses several topics that you may wish to learn more about; we have provided links for the following:
Target Audience
Neurologists, NPs and PAs specializing in neurology.
Statement of Need
PD has traditionally been classified as a movement disorder as its cardinal symptoms include tremor, rigidity, slowed movement and postural instability. However the importance of psychiatric and other non-motor symptoms (NMS) in the detection of disease and their impact on quality of life has forced clinicians to envision PD as a complex disorder that requires careful and thorough evaluation throughout their patients’ lifetimes. It is necessary to understand that NMS often present early in disease, and it is the worsening of these symptoms that may spur individuals to seek medical attention. With disease progression, these symptoms invariably become more debilitating and are a clinical challenge to control over the long run. In addition to dopaminergic therapy, patients may require additional pharmacologic agents to control symptoms, adding to their burden of cost and complexity as they seek to sustain quality of life.
Learning Objectives
At the conclusion of this activity, participants should be able to:
- Identify potential biomarkers for tracking the development and progression of PD
- Name non-motor features that can be useful as supportive features in early diagnosis of PD
- Describe challenges in the early diagnosis of PD
Disclosures
Andrew Siderowf, MD (Case Study Contributor)
Gary VanderArk, MD (Independent Reviewer)
Richard Robinson (Medical Writer)
Accreditation Statement
intellyst® Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
intellyst® Medical Education designates this activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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| If it could be shown that the level of alpha-synuclein in the cerebrospinal fluid (CSF) falls the longer a person has Parkinsons disease (PD), then CSF alpha-synuclein may serve as a: |
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| Large epidemiological studies have suggested that ____ levels of serum urate are associated with lower risk of PD, and a ____ rate of disease progression: |
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| Which of the following statements is NOT true about dopamine transporter (DaT) imaging with SPECT? |
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| In a patient presenting with mild, unilateral hand tremor, which of the following would most suggest Parkinsons disease rather than essential tremor? |
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| A patient who has difficulty looking down and has begun to fall soon after the development of parkinsonism may have: |
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| A 65-year old male with a history of orthostatic hypotension and impotence has developed tremor and rigidity. A diagnosis made more likely due to this COMBINATION of symptoms is: |
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| A patient presents with mild tremor, rigidity, slowed movements, slight postural instability, and mild sensory loss. Should this patient be referred for neuroimaging with DaTSCAN to aid in diagnosis? |
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Why or why not?
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| According to the American Academy of Neurology, which depression scale(s) is(are) probably useful in the evaluation of depression in PD patients? |
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Please indicate your level of agreement with the following statement, with "1" indicating reject completely, and "5" indicating accept completely:
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| A patient presents with significant unilateral tremor, present at rest and with action. The patient has other nonspecific complaints, but the exam reveals no other definitive features suggesting which movement disorder she has. This patient should be referred for neuroimaging with DaTSCAN to aid in diagnosis. | |
What would be the value to your practice of using clinical rating scales in the routine evaluation of your patients?
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Please evaluate the activity objectives by selecting how well each has been met, with 5 indicating excellent and 1 indicating poor.
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| Identify potential biomarkers for tracking the development and progression of PD | |
| Name non-motor features that can be useful as supportive features in early diagnosis of PD | |
| Describe challenges in the early diagnosis of PD | |
Please evaluate the effectiveness of the case study by Dr. Andrew Siderowf, in both areas listed below, with 5 indicating excellent and 1 indicating poor.
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| Usefulness of information presented. | |
| Objectivity/fair balance of content. | |
| Do you intend to make changes or apply this information to your practice as a result of this activity? |
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Please explain your response to the above question:
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| Was there any commercial bias in relation to this activity? |
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If yes, please describe:
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NEW!!! We will be posting an Ask the Expert section of subsequent issues of Physician Focus on Parkinsons. Please take this unique opportunity to ask a question of our editorial board (Lawrence Elmer, MD; Robert Hauser, MD; Lauren Seeberger, MD; Andrew Siderowf, MD). Your question and the expert panel response may be published in the next issue.
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