Clinical aspects of stroke

Question 1

What is the FAST test?

Answer 1

Face
Arm
Speech
Test/Time
Rapid Ambulance Protocol

Question 2

Give examples of stroke mimics which are actually systemic problems with CNS effects?

Answer 2

Hypoglycaemia
Delirium
Decompensation

Question 3

What are stroke mimics which are rather primary CNS problems?

Answer 3

Partial (focal) epilepsy
Migraine aura (with/without headache)
Multiple sclerosis
Transient global amnesia
Functional presentations
Intoxication

Question 4

What are some risk factors for stroke?

Answer 4

Hypertension, TIA, diabetes mellitus, cardiac disease, obesity, hypercholesterolaemia, alcohol, smoking, physical inactivity (no particular order)

Question 5

What is the term that describes problems with elocution

Answer 5

Dysarthria / dyspraxia

Question 6

What is the term that describes problems with understanding?

Answer 6

Receptive dysphasia

Question 7

What is the term that describes problems with speaking?

Answer 7

Expressive dysphasia

Question 8

What is the name given to problems with repeating?

Answer 8

Conductive dysphasia

Question 9

What are the components of language testing?

Answer 9

Understanding Expression
Naming
Repetition
Reading
Writing

Question 10

What is Broca’s aphasia?

Answer 10

Broca’s aphasia results from injury to speech and language brain areas such the left hemisphere inferior frontal gyrus, among others. Stilted, stuttering speech

Question 11

What is Wernicke’s aphasia?

Answer 11

Wernicke’s aphasia results from damage to the superior temporal lobe
Word salad’
Fluent, but with impaired comprehension and insight.
Phonemic paraphasias (e.g. “bap” for “map”)
Semantic paraphasias (e.g. “knife” for “fork”)

Question 12

What is Gertsmann syndrome?

Answer 12

rare neurological disorder consisting of a tetrad of symptoms which include impairment in performing calculations (acalculia), discriminating their own fingers (finger agnosia), writing by hands (agraphia) and impairment of distinguishing left from right (left-right disorientation).

Question 13

How do you test for neglect?

Answer 13

Observe
Ask
Distinguish and exclude primary defects e.g. hemianopia

Question 14

What is delirium?

Answer 14

Delirium is an acute fluctuating disorder of attention and awareness, which often complicates the clinical course of several conditions, including acute stroke

Question 15

What are the risks of stroke patients who develop delirium?

Answer 15

4.7 x Inpatient mortality
4.9 x 12 month mortality
9.4 days longer stay
Have a greater degree of functional impairment at discharge, 3, 6 and 12 months
More likely to develop dementia
3.4 x more likely to be discharged to a nursing home or other institution