BGSU

Freddie Falcon's Grandma

Multiple Choice

On arrival to the ER, Freddie's mom tells him that his grandmother has an occlusion to an artery in her brain. What type of Stroke is most likely?

• Subarachnoid hemorrhage

• Subdural hemorrhage

• Ischemic

Type of Stroke: Did you remember?

• An ischemic stroke is the only option that results from an occlusion of blood vessels that supply the brain.

• Subarachnoid hemorrhage is a bleed between the pial and arachnoid membranes, most often the result of an aneurysm rupture

• A subdural hemorrhage is a bleed between the brain surface and the dura mater, most often the result of trauma

Multiple Choice

Which of the following diagnostic tests performed in the ER would have detected the occlusion in her brain?

• Xray

• CT or MRI of the head

• Partial thromboplastin time

• Diffusion tensor imaging

CT or MRI

• Great work so far!

• A CT of the head is typically performed to identify an occlusive stroke in the ER

• In some cases, an MRI is performed to pick up more detailed or smaller findings that may have been missed by CT

Multiple Choice

Good News! The doctor's tell Freddie and his family that because grandma Falcon came in to the ER so quickly, she can receive a medication designed to break up the clot. Which medication did Grandma Falcon most likely receive?

• Tissue Plasminogen Activator (tPA)

• Aspirin

• Metoprolol

• Adenosine

Tissue Plasminogen Activator (tPA)

• If you struggled with this question, review your acute CVA management module!

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Multiple Choice

Grandma Falcon is ready to begin PT! As a PT student, Freddie Falcon is watching and learning! Which of the following values may be a concern for mobilizing Grandma Falcon today?

• Hgb of 8.4 g/dL

• INR of 5.4

• Troponins of .1 ng/mL x 3 measurements

Lab Values Review!

• Hgb: Hemoglobin - Normal hemoglobin is approximately 12-16 g/ dL for females and 13-17 g/dL for females. While 8.4 is low, it is not unsafe to mobilize at this level, provided the patient is asymptomatic.

• INR: International Normalized Ratio- To be therapeutic, depending on the condition values should be between 2.0 and 3.5. Values greater than 5 place a patient at a high risk for bleeding and may be unsafe for mobilization

• Troponins: A normal value for Troponins is <.2ng/dL. Troponin trends are also tracked and the fact that grandma Falcon's are stable is a good thing.

Thanks for helping Freddie to learn more about Grandma Falcon's stroke! Please return to the module to learn more about how to rehabilitate her.

• References: Goodman, C., Heick J., Lazaro, R. Differential Diagnosis for Physical Therapists, 6th edition. Elsevier. 2018. ISBN: 9780323478496

• Nichols-Larsen D, et. Al. Neurologic Rehabilitation: Neuroscience and Neuroplasticity in Physical Therapy Practice. China: McGraw Hill Education; 2016. ISBN: 978-0-07-180715-9

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