AIIMS Delhi NO - 2017
Medical & Surgical Nursing
Medium
Which manifestation is not seen in Parkinson's disease?
Appeared in: AIIMS Delhi NO - 2017
Explanation
- Anhedonia, the inability to feel pleasure, is classified as a non-motor (neuropsychiatric) symptom of Parkinson's disease.
- While it is a common finding, often associated with depression in these patients, it is distinct from the cardinal motor features of the disease.
- The question contrasts this non-motor symptom with three classic motor manifestations, making anhedonia the correct answer as the outlier.
Why Other Options Were Wrong
- Option B: Resting tremor is a cardinal motor sign of Parkinson's disease, often described as a 'pill-rolling' motion of the fingers. It is one of the most common presenting symptoms.
- Option C: A shuffling gait is a characteristic feature of Parkinson's disease, resulting from bradykinesia (slowness of movement) and postural instability. Patients take small steps and have reduced arm swing.
- Option D: Drooling (sialorrhea) is a common motor-related symptom in Parkinson's disease. It is not due to overproduction of saliva but rather to impaired automatic swallowing movements.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Differentiating between motor and non-motor symptoms of Parkinson's disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must perform holistic assessments for both motor and non-motor symptoms. Non-motor symptoms like depression and anhedonia severely impact a patient's quality of life and require specific interventions, such as counseling or antidepressant therapy.
- Recognizing the full spectrum of symptoms allows for comprehensive care planning that addresses both physical disability and psychological distress.
- What if? If a patient with Parkinson's reports feeling constantly sad and having lost interest in all activities, the nurse should screen for depression, as anhedonia is a core symptom. This requires referral and management, not just focusing on motor symptoms.
How to Approach the Question
- First, analyze the question to identify the core concept: symptoms of Parkinson's disease. Note the negative framing ('not seen').
- Recall the classic motor symptoms of Parkinson's, often remembered by the acronym TRAP: Tremor (at rest), Rigidity, Akinesia/Bradykinesia, and Postural instability.
- Evaluate each option and categorize it as either a motor (movement-related) or non-motor (psychiatric, sensory, autonomic) symptom.
- Recognize that 'Resting Tremors,' 'Shuffling gait,' and 'Drooling' are all direct consequences of the motor system dysfunction in Parkinson's.
- Identify 'Anhedonia' as a neuropsychiatric (non-motor) symptom, related to mood.
- Conclude that the non-motor symptom is the intended answer, as it is different from the other three classic motor signs.
Concept Tested & Keywords
- Concept Tested: Differentiating between motor and non-motor symptoms of Parkinson's disease.
- Stem keywords: Parkinson's disease, manifestation
- Lead-in keywords: not seen
- Negative lead-in flag: The question asks to identify the manifestation that is NOT a characteristic motor symptom of Parkinson's disease.
Question ID
Q0DW4FL8JgyAixvIWj8ovQ
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 1844-1846
E6 Medicine Harrison 22e Part 1 p. 219-221
E6 Pharmacology Nursing Lilley 11e Part 1 p. 253-255
Practise the full AIIMS Delhi NO - 2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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