Unit 2 content

Question 1

How many people die of stroke

Answer 1

1 in 5

More women than men

Question 2

What are the 2 types of stroke and which is more prevelant

Answer 2

Ischemic and Hemorrhagic

ischemic strokes account for 80% of all strokes

Question 3

What is a thrombus

Answer 3

Platelet aggregation that forms and blocks flow

Question 4

What is an Embolism

Answer 4

forms elsewhere in the body then lodged in a blood vessel in the brain blocking blood flow

Question 5

What is atherosclerosis

Answer 5

build up of plaque that blocks blood flow

Question 6

What is the pathophysiology of a stroke

Answer 6

Release of glutamate
Altered Ca ion channels cause influx of Ca into neurons
Activation of destructive Ca sensitive enzymes
Further neuronal cell death

Question 7

What are the signs of a stroke

Answer 7

FAST

face, arm, speech, time

Question 8

What are the signs of an ACA infarct

Answer 8

Contralateral hemiparesis
Mostly lower extremity sensory loss
Confusion

Question 9

What are the symptoms of a MCA infarct

Answer 9

Mostly upper extremity sensory loss and weakness
Visual problems - homonymous hemianopsia
Neglect if non dominant hemisphere
Apraxia if dominant hemisphere
Aphasia

Question 10

What are the symptoms of a PCA infarct

Answer 10

Homonymous hemianopsia

Contralateral transient hemiparesis or plegia and sensory loss`

Question 11

What drug is useful for destroying clots and how should it be administered

Answer 11

tPA
3 hours of stroke symptoms
not to be used in hemorrhagic stroke

Question 12

What are some characteristics of right sided stroke

Answer 12

Difficulty with ambulating without realizing it

Question 13

What are some characteristics of left sided stroke

Answer 13

more likely to have aphasia and apraxia
aware of limitations
may have clinical depression

Question 14

What are the requirements for entering subacute care for a stroke

Answer 14

tolerate therapies for 3 hours a day 6 days a week for 2 separate disciplines

Question 15

What are the requirements for entering chronic care for a stroke

Answer 15

diagnosis lasts 6 months

Patient comfortable entering and exiting own home

Question 16

Briefly describe Parkinson’s disease

Answer 16

Slowly progressive neuro-degenerative disorder of the basil ganglia

Question 17

what gender is affected more by Parkinson’s and at what rate

Answer 17

Men 1.2-1.5 times more likely

Question 18

What are the common etiologies for Parkinson’s

Answer 18

Idiopathic
genetic - 10%
Secondary
- toxins, medication, multi infarct vascular disease

Question 19

What is Normal pressure hydrocephalus

Answer 19

disease that can look like Parkinson’s but isn’t
Causes increase in the amount of cerebrospinal fluid
Large ventricles that compress parts of the brain
Shuffling, incontinence, and cognitive decline
No tremor
Treat with shunt

Question 20

Describe the pathophysiology of Parkinson’s

Answer 20

Degeneration of dopamine producing neurons in the basal ganglia

Question 21

What are the cardinal features of Parkinsins

Answer 21

TRAP
Tremors
Rigidity
Brady/Akinesia
Postural instability

Question 22

What are some secondary motor symptoms of Parkinson’s

Answer 22

stooped kyphotic posture
Extensor weakness and flexor tightness
Start hesitation
difficulty dual tasking

Question 23

What are some non motor symptoms of Parkinson’s

Answer 23

Depression and anxiety
Psychosis
Orthostatic hypotension
Dysphagia
Lack of smell

Question 24

What are the HY classifications for Parkinson’s

Answer 24

1 - minimal disability, unilateral symptoms
2 - bilateral or midline involvement
3 - postural instability, lives independently
4 - all symptoms, walking and standing only possible with assistance
5 - chair or bed bound

Question 25

What drugs are used to treat Parkinson’s

Answer 25

Levodopa and Carbidopa
avoid large protein meals with these medications
Carbidopa helps levodopa reach the brain

Question 26

What is end of dose deterioration

Answer 26

when the medication effectiveness fades

Question 27

What is the on-off phenomena

Answer 27

unpredictable and random return of symptoms

Question 28

What is DBS and what does it do

Answer 28

Deep brain stimulation
implanted electrode
reduces tremors, motor fluctuations and the amount of medication needed