lOMoARcPSD|14220795
Parkinson's (tremor) exam mock marksheet
Medicine (University College London)
StuDocu is not sponsored or endorsed by any college or university
Downloaded by Jess Vin (pavedin421@duetube.com)
lOMoARcPSD|14220795
uclumedicalsociety
SECTION OF EDUCATION
Parkinson’s/Tremor Examination
P
Introduction
WIPER QQ
Inspection
End of the bed – Walking aids, Medications
Close review – Hypomimia/mask-like facies, resting pill-rolling tremor, blepharoclonus (tremor
in eyelids), Tardive dyskinesia (side effect of medication), monotonous voice, drooling
Gait
Candidate looks for:
 Festinant gait

Stooping posture

Decreased arm swing

Difficult turning or walking through passages
Arms
Candidate assesses presences of a resting tremor AND uses distraction technique to exacerbate
if neccessary
Candidate assesses other tremor types including postural and intention
Candidate assesses tone – lead pipe rigidity and cogwheeling
Candidate assesses bradykinesia – finger tapping, arm flapping, foot stamping
Face
Assesses eye movements – loss of upwards gaze may indicate supranuclear palsy
Offers to perform glabellar tap
Assesses speech – baby hippopotamus, British constituition
Function
Asks patient to write a sentence – evidence of micrographia
Draw a spiral – to assess tremor
Ask patient to do up a button
Finishing off
Offers to look at drug chart to assess presence of Parkinsonian drugs
Offers to measure lying and standing BP – postural drop may indicate MSA
Candidate states they would like to perform a full neurological examination including cerebellar
– to assess possible MSA
Offers to perform cognitive function tests – Lewy body/Parkinsonian dementia
Candidate thanks patient
Candidate washes hands
Diagnosis
Candidate summarises findings
Candidate offers a relevant diagnosis
Candidate suggests appropriate management
Extra points
Overall impression
© UCLU Medical Society 2013
Original markschemes: UrSCE 2012
(Dr Jonathan King)
Downloaded by Jess Vin (pavedin421@duetube.com)
B