PBL 1

Question 1

what are the functions of the frontal lobe?

Answer 1

emotional expression
personality
problem solving
judgement
motor function
language
motivation
social behaviour

Question 2

what are the symptoms of a frontal lobe stroke?

Answer 2

hemiparesis or hemiplegia
speech difficulties
dysphagia
ataxia
incontinence
impaired spatial reasoning
vascular dementia 
behaviour changes
personality changes
cognitive deficits e.g. making decisions

Question 3

what is hemiparesis?

Answer 3

weakness or the inability to move on one side of the body

Question 4

what is dysphagia?

Answer 4

issues with swallowing

Question 5

what is ataxia?

Answer 5

difficulty with coordinated movement

Question 6

what are the functions of the temporal lobe?

Answer 6

processing emotions
language
certain aspects of visual and audiotory perception
understanding language
learning
memory
face recognition

Question 7

what are the symptoms of a temporal lobe stroke?

Answer 7

poor memory
prosopagnosia
fluent aphasia - speak fluently but use the wrong words
difficulty with depth perception
trouble with sound
emotional and behavioural changes

Question 8

what are the functions of the parietal lobe?

Answer 8

learned skills e.g. reading, writing, calculations
recognition of objects
spatial awareness
ability to perform complex skills e.g. driving a car

Question 9

what are the symptoms of a parietal lobe stroke?

Answer 9

aphasia
spatial neglect
vision changes - most likely results in inferior quadrantanopia 
proprioception dysfunction
executive function
Gerstmann syndrome

Question 10

what is Gerstmann syndrome?

Answer 10

a parietal lobe stroke in te dominant hemisphere can result in this syndrome which is characterized by difficulty with left-right orinetation, agraphia, acalculia and finger agnosia
can also be caused by brain tumour, MS and aneurysm of MCA

Question 11

what are the functions of the occipital lobe?

Answer 11

spatial processing, ability to distinguish between different cokours, spatial awareness, colour and object recognition, hand eye coordination

Question 12

what are the symptoms of an occipital lobe stroke?

Answer 12

cortical blindness
partial vision loss
visual hallucinations
homonomous hemianopia 
central vision defect

Question 13

what is aphasia?

Answer 13

loss of ability to understand or express speech

Question 14

what is Alexia?

Answer 14

inability to read despite recognising letters

Question 15

Outline the blood supply to the eye?

Answer 15

off the optic nerve we get the ciliaryartery which branches into short and long posterior ciliary arteries.
short posterior ciliary arteries pierce the back of the sclera to enter the choroid layer whilst long posterior ciliary arteries pass around the eyeball to pierce the sclera in the anterior portion of the eye
central artery of retina supplies the internal surface of the retina (it pierces the optic nerve to enter the retina at the optic disc)

Question 16

what do the short posterior ciliary arteries supply?

Answer 16

the choroid and parts of the optic nerve

Question 17

what do the long posterior ciliary arteries supply?

Answer 17

ciliary bodies

Question 18

what forms the major arterial circle of the iris?

Answer 18

long posterior ciliary arteries and the anterior ciliary arteries

Question 19

what do the anterior ciliary arteries supply?

Answer 19

rectus muscles, conjunctiva, and sclera

Question 20

what does the central artery of the retina supply?

Answer 20

the internal surface of the retina

Question 21

what happens if we get a central retinal artery occlusion?

Answer 21

sudden loss of eyesight

Question 22

outline the venous draianage of the eye?

Answer 22

2 superior vortex veins drain into the superior opthalmic vein
2 inferior vortex veins drian into the inferior opthalmic veins
the opthalmic veins draininto the cavernous sinus
the central retinal vein also drains into this

Question 23

What thrombolysis drug is used as secondary stroke prevention?

Answer 23

alteplase if caught within 4.5 hours

Question 24

what is dysphasia?

Answer 24

a language disorder marked by deficiency in the generation of speech and sometimes also in its compregension

Question 25

what is expressive dysphasia?

Answer 25

brocas area problem - difficulty producing language

Question 26

what is receptive dysphasia?

Answer 26

disorder of wernickes area so patients speak fluently but the words dont make sense

Question 27

what is dysarthria?

Answer 27

difficulty or unclear articulation of speech that is otherwise linguistically normal

Question 28

outline the steps towards platelet aggregation?

Answer 28

after endothelial damage, collagen is exposed so endothelial cells secrete vWF. vWF binds to exposed collagen and circulating platelets have gp1B receptors which can bind to this vWF. Now platelets are connected to the collagen so they become activated, change shape and express the gp2b/3a receptors. Anchored platelets secrete alpha granules which release vWF and platelet derived growth factor, and they secrete dense granules which release ADP and thromboxane. These then activate more platelets. Circulating fibrinogen can bind to the gp2b/3a receptors which allows platelets to adhere to one another, forming a plug

Question 29

what type of drug is aspirin?

Answer 29

NSAID and antiplatelet

Question 30

whats the moa of aspirin?

Answer 30

inhibits COX which inhibits thromboxane production, inhibiting clotting

Question 31

what type of drug is clopidogrel?

Answer 31

an antiplatelet drug

Question 32

what is clopidogrel’s moa?

Answer 32

irreversibly inhibits the binding of ADP to its platelet P2Y12 receptor and the subsequent ADP- mediated activation of the glycoprotein GPIIb/IIIa complex, thereby inhibiting platelet aggregation.

Question 33

what type of drug is dipyridamole?

Answer 33

an antiplatelet drug

Question 34

what is dipyridamole’s moa?