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Parkinson's disease — UKMLA MCQ

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MediumNeurologyParkinson's diseaseUKMLAMRCP Part 1

A 70-year-old patient with Parkinson's disease experiences significant bradykinesia and rigidity affecting daily activities. According to NICE guidelines which medication is the preferred initial treatment in an older patient whose symptoms impact quality of life?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Levodopa combined with a dopa-decarboxylase inhibitor

NICE guidelines recommend levodopa combined with a peripheral dopa-decarboxylase inhibitor as the most effective treatment for motor symptoms in older patients or those with significant impact on quality of life. Dopamine agonists or MAO-B inhibitors can be considered in younger patients or milder disease. Anticholinergics are rarely used due to side effects.

Reference: NICE Parkinson's disease guideline