Phys Clinical Cases · geriatric
Parkinson's Disease in Older Adults — DCE Clinical Case
DCE long-case and short-case station for Parkinson's Disease in Older Adults.
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FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Parkinson's Disease in Older Adults.
Parkinson's Disease in Older Adults — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Parkinson's Disease in Older Adults. [1]
Presenting complaint: Subacute or acute symptoms referable to Parkinson's Disease in Older Adults, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References3ShowHide
- [1]Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord, 2015.PMID 26474316
- [2]Armstrong MJ, Okun MS Diagnosis and Treatment of Parkinson Disease: A Review. JAMA, 2020.PMID 32044947
- [3]Cummings J, Isaacson S, Mills R, et al. Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial. Lancet, 2014.PMID 24183563