Physician Focus on Parkinson's
Issue 16 (Winter 2010) - Quarterly CME Newsletter on Parkinson's Disease
To receive CME credit for this activity, please complete the post-test and evaluation below. Once submitted, a certificate will be issued within two weeks to the email address provided.
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Target Audience Neurologists, NPs and PAs specializing in neurology.
Statement of Need
Parkinson’s disease (PD) is the second most common neurodegenerative disease. The mean age of onset is 61 years, but may begin as early as age 40 or less. It affects an estimated half million to one million Americans. That number is expected to double in the next 25 years as the population ages and as treatments for other diseases prolong the survival of aging adults. PD is classified as a movement disorder, because its most prominent symptoms are tremor, rigidity, slowed movements, and postural instability. However, PD also includes a wide range of non-motor symptoms, including depression, anxiety, sleep disorder, and autonomic symptoms, and these may be at least as debilitating as motor symptoms for many patients.
Learning Objectives At the conclusion of this activity, participants should be able to: • Discuss non-motor features of Parkinson’s disease and their impact on quality of life, including, anxiety, depression, cognitive changes, sensory symptoms, and sleep disorders • Describe medications available for treatment of motor symptoms of Parkinson’s disease in early and fluctuating disease as well as their side effects • Summarize the unique nature of the delayed-start clinical trial design and its value in testing potential disease modifying agents in Parkinson’s disease
Disclosures Lawrence Elmer, 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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The most common surgical procedure performed for advanced Parkinsons disease is: |
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Results from three clinical trials of pedunculopontine nucleus DBS are best characterized as: |
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A 70-year-old patient with a 12-year history of PD has developed disabling dyskinesias, significant off time, continued good response to levodopa, mild cognitive impairment, and prominent autonomic dysfunction. Overall, is this patient a good candidate for deep brain stimulation surgery? |
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In a randomized trial, Williams et al. found that DBS surgery was superior to best medical management in: |
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In an in-depth interview of five caregivers, Roland et al. found that ____ was a much more important source of stress than ____. |
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For PD caregivers who are developing significant stress, the best initial option(s) may be: |
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According to a small placebo-controlled trial, a possible treatment for pathological gambling in PD is: |
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A PD patient under your care has developed an impulse control disorder while on a dopamine agonist. Upon your recommendation, the patient has begun to taper the dopamine agonist. He is now complaining of anxiety, panic attacks, and depression. What is the best course of treatment for this patient? |
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Evidence that nursing home placement for a PD patient may be near includes: |
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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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PD patients with depression are not good candidates for DBS surgery, because of the risk of suicide. | |
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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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Discuss non-motor features of Parkinsons disease and their impact on quality of life, including anxiety, depression, cognitive changes, sensory symptoms, and sleep disorders | |
Describe medications available for treatment of motor symptoms of Parkinsons disease in early and fluctuating disease as well as their side effects | |
Summarize the unique nature of the delayed-start clinical trial design and its value in testing potential disease-modifying agents in Parkinsons disease | |
Please evaluate the effectiveness of the case study by Dr. Lawrence Elmer, 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 perceived in relation to this activity? If yes, please describe.
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Is there anything you would like to communicate to the authors?
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Suggest topics you would like to see in future activities.
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