S3 Short term stroke management

Question 1

What are the common acute complications of stroke? (4)

Answer 1

Weaknesses - limbs, oropharyngeal muscles
Language problems
Blood pressure rises

Question 2

What is the result of damage to Broca’s area? (2)

Answer 2

Flow of speech is stilted. Difficulty finding words.

Question 3

What is the result of damage to Wernicke’s area? (3)

Answer 3

Neologisms - made up words
Mistake closely related words
Comprehension, reading and writing impaired

Question 4

When are antihypertensives recommended post stroke? (4)

Answer 4

Intracerebral haemorrhage
Hypertensive complications
Aortic dissection
Eclampsia/pre-eclampsia

Question 5

How is a safe swallow assessment conducted?

Answer 5

1 tsp water, then 2 tsp then 50ml.

Check for drooling, coughing, choking, wet voice or cough

Question 6

How do pressure ulcers form? (3)

Answer 6

Sustained pressure over bony prominence
Friction/shear forces
Moisture from sweat/incontinence

Question 7

What are the risk factors for pressure ulcers? (6)

Answer 7

Immobility
Malnutrition
Diabetes
Smoking
Terminal illness
Sensory impairment

Question 8

Why might joint pathologies reveal themselves after a stroke?

Answer 8

Compensation for weakness on affected side increases the use of the unaffected side.

Question 9

What are the features of post-stroke pain? (3)

Answer 9

Decreased sensation.
Paraesthesia, burning/shooting pains.
Dysthaesia (unpleasant sensation when touched)

Question 10

What does post stroke pain respond to? (3)

What doesn’t it? (3)

Answer 10

Anti-epileptics: pregabalin, gabapentin.
Amitryptiline.

Opiates, paracetamol, non-steroidal anti-inflammatories.

Question 11

How many people are affected by post stroke pain?

Answer 11

50%