Pathophysiology of Stroke 11_19_12

Case chief complaint can barely speak and has

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Case Chief complaint: “can barely speak and has weakness in her right arm that made her drop her glass of orange juice” HPI: JL is a 74 year-old female presenting to the ED with her husband. Her husband explained that all of a sudden she started experiencing weakness in the right side of her body and he noticed a right-sided facial droop.
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Case PMH: hypertension, atrial fibrillation, hyperlipidemia FH: not significant SH: + tobacco, occasional alcohol use Allergies: NKDA Medications: Hydrochlorothiazide 25 mg daily Lisinopril 10 mg daily Aspirin 81 mg daily
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What risk factors does JL have for ischemic stroke? Question 1 Which of her risk factors is not modifiable?
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Question 2 What is JL’s annual risk of stroke according to her CHADS2 score? a) 0 b) 1 c) 2 d) 3 e) 4
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Question 3 Which of the following risk factors included in the CHA2DS2-VASc score does JL have? a) Vascular disease b) Age c) Sex category d) a & b e) b & c
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Case JL’s ECG revealed atrial fibrillation and her CT scan the following day showed evidence of an infarct in her left middle cerebral artery. She was subsequently diagnosed with an acute ischemic stroke
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Question 4 Which of the following is true regarding the pathophysiology of JL’s stroke? a) Her stroke may cardioembolic because of her history of atrial fibrillation b) Her stroke may be related to the aspirin she was taking c) Her stroke may be due to atherosclerotic plaque rupture since she has hyperlipidemia d) a & c e) All of the above
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