module 8 case studies Flashcards
Could this possibly be classified as a TIA? Explain your reasoning
No, because Mrs. R’s condition has worsened after 36 hrs when a second CT scan showed increased density, whereas a TIA does not create any damage
The ECG results were normal, however, could you suggest anything more specific about the cause of Mrs. R.’s condition if an ECG actually revealed atrial fibrillation? Explain your answer
Embolic stroke because atrial fibrillation common cardiac conditions causes an emboli
If her signs and symptoms were different and she was actually experiencing only motor hemiplegia accompanied by dysarthria, would your diagnosis change? If it does change, what would it be?
Lacunar (small vessel) stroke
Would your diagnosis change if the first CT scan had actually shown an abnormal result? Why/why not?
Yes, it would because you would see blood in the brain which would be hemorrhage stroke
Why is a CT scan of vital importance in the diagnosis of a stroke? (Hint: consider a main difference in treatment between the two main categories of stroke.)
A CT scan is vitally important in the diagnosis of a stroke because it provides an increased amount of information on the location of the occulsion. It also can quickly show whether you are suffering from an ischemic or hemorrhagic stroke which will provide the treatment method needed.
Ischemic = thrombolytic agent to break up clot, hemorrhage = stop the bleeding
Based on Mrs. R.’s manifestations, which cerebral artery (anterior, middle, posterior) was probably affected? Identify (google “stroke acronym“) and explain the common acronym that is associated with this type of stroke (hint: because this is the most common type of stroke, this is used as a tool for recognizing someone experiencing a stroke.)
The cerebral artery that was probably affected was the middle artery. The acronym that is commonly used FAST. F stands for facial drooping which can be “measured” by asking the patient to smile, A stands for arm weakness which can be “measured” by asking the person to raise their arms, S stands for speech difficulties which can be “measured” by asking the person to repeat a phrase and T stands for time which is determined by observing the amount of time it takes for the person to complete the other three tasks and contacting help.
What are the risk factors present in this case?
Age, sex, smoking, diabetes, previous TIA’s, hypertension, overweight
Propose in which side of the brain the later CT scan showed a change in density. Support your conclusion
Left side of brain because of the cross over, speech centre is on the left side which is why she is having aphasia, motor issues are on the right side
What is the medical term for loss of the same side of vision in both eyes?
Hemianopia (homonymous = same side on both eyes)
What is the medical term for Mrs. R.’s speech impairment?
Broca’s aphasia
What is Lisa’s initial Glasgow coma scale score?
Glasgow scale = confused 4, eye opening 4, obeys commands 6 = 14
Choose between the following pairs representing different categories of brain trauma that Lisa is likely experiencing. Primary and/or secondary? Closed and/or open? Focal and/or diffuse
Primary = damage caused by impact, closed – her brain content is not exposed, focal – extradural hematoma caused from impact of hitting head & diffuse – loss consciousness (less than 6 hours)
Disruption of what structure(s) must have occurred to cause Lisa’s initial loss of consciousness?
RAAS system, both cerebral hemispheres
Suggest a possible reason for Lisa’s deteriorating condition.
Intercranial pressure from hematoma
Name her present level of consciousness and justify your choice
Obtundation because she is sleepy and having trouble staying awake
