Post-Stroke Complications Management Flashcards
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Read the first 7 Post-Stroke Complications Management flashcards as text
Which post-stroke cognitive domain is MOST commonly impaired and often detected earliest using bedside screening tools?
Answer: Attention and processing speed
Attention and processing speed deficits are the most prevalent post-stroke cognitive impairments and are sensitively captured by tools like the MoCA and Trail Making Test.
A stroke coordinator notes a patient's oxygen saturation dropping to 88% during sleep on post-stroke day 3. The MOST appropriate next step is:
Answer: Order overnight polysomnography or oximetry study for sleep apnea evaluation
Sleep-disordered breathing affects up to 70% of stroke patients; formal sleep study confirms the diagnosis before committing to CPAP therapy.
Pathological crying or laughing (pseudobulbar affect) after stroke is BEST treated with:
Answer: Dextromethorphan/quinidine (Nuedexta) or SSRIs
Dextromethorphan/quinidine is FDA-approved for pseudobulbar affect; SSRIs are also effective alternatives for post-stroke emotional incontinence.
A patient is 10 days post-left hemispheric stroke and has difficulty speaking but seems to understand commands. Which complication MOST likely explains this presentation?
Answer: Broca's aphasia
Broca's (expressive) aphasia causes non-fluent speech with relatively preserved comprehension, localizing to the left inferior frontal gyrus.
Which rehabilitation approach has STRONGEST evidence for improving upper limb function after stroke?
Answer: Constraint-induced movement therapy (CIMT)
CIMT, which constrains the unaffected limb and forces use of the paretic arm, has strong RCT evidence for meaningful functional improvement in eligible patients.
Post-stroke hypertension management in the chronic phase (>72 hours) aims to reduce SBP to what target to prevent recurrent stroke?
Answer: <130 mmHg in most patients per current AHA/ASA guidelines
The 2021 AHA/ASA guidelines recommend a BP target of <130/80 mmHg for most ischemic stroke survivors to reduce recurrence risk.
A post-stroke patient on a rehabilitation unit develops sudden-onset pleuritic chest pain and tachycardia on day 12. Oxygen saturation drops to 92%. What is the MOST likely diagnosis?
Answer: Pulmonary embolism from DVT
Stroke patients are at high risk for DVT due to immobility; PE presenting with pleuritic pain, tachycardia, and hypoxia in the second week is a classic post-stroke scenario.