PATHOPHYSIOLOGICAL PROCESS TEMPLATE DISEASE: Iscahmic stroke DEFINITION: AETIOLOGY: PATHOGENESIS: CLINICAL FEATURES: COURSE OF DISEASE: COMPLICATIONS: PROGNOSIS: DIAGNOSIS: TREATMENT: PREVENTION:...

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PATHOPHYSIOLOGICAL PROCESS TEMPLATE


DISEASE: Iscahmic stroke


DEFINITION:


AETIOLOGY:


PATHOGENESIS:


CLINICAL FEATURES:


COURSE OF DISEASE:


COMPLICATIONS:


PROGNOSIS:


DIAGNOSIS:


TREATMENT:


PREVENTION:




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PATHOPHYSIOLOGICAL PROCESS TEMPLATE DISEASE: Iscahmic stroke DEFINITION: AETIOLOGY: PATHOGENESIS: CLINICAL FEATURES: COURSE OF DISEASE: COMPLICATIONS: PROGNOSIS: DIAGNOSIS: TREATMENT: PREVENTION:






PATHOPHYSIOLOGICAL PROCESS TEMPLATE DISEASE: Iscahmic stroke DEFINITION: AETIOLOGY: PATHOGENESIS: CLINICAL FEATURES: COURSE OF DISEASE: COMPLICATIONS: PROGNOSIS: DIAGNOSIS: TREATMENT: PREVENTION: Marking criteria and standards: Assessment 1 – Case study PATHOPHYSIOLOGY TEMPLATE CRITERIA/20 HD 17- 20 D 15 16.5 C 13.5 - 14.5 P 10 - 13 F ≤ 9.5 Demonstrates comprehensive knowledge of the aetiology, pathogenesis, clinical manifestations, diagnosis, treatment, course, prognosis and prevention of an ischaemic stroke of the dominant left cerebral hemisphere. Accurately, concisely and clearly summarises all of the most important information for each component of the template with all information supported by a discerning selection of authoritative sources. The information is relevant to an ischaemic stroke of the left dominant cerebral hemisphere. Accurately, concisely and clearly summarises most information for each component of the template with most of the information clearly supported by authoritative sources. The information is relevant to an ischaemic stroke of the left dominant cerebral hemisphere. Information is accurately summarised. There may be omissions of some of the information or summary may lack clarity in some areas. Information is generally supported by relevant sources. Information is generally relevant to an ischaemic stroke of the left dominant cerebral hemisphere. Information from most components of the template has been summarised but lacks clarity, conciseness and at times may not be specific. The sources of information are not always clearly evident. Minimal information included for the components of the template with significant omissions or lack of clarity. Information poorly summarised. Sources of information not clearly evident and information may not always be relevant to an ischaemic stroke of the left cerebral hemisphere. (5-9.5) Poor or significantly inaccurate information included and poorly summarised. Significant omissions of important information with sources of information either not identified, unclear or predominantly from non-authoritative sources. Information may not always be relevant to an ischaemic stroke of the left cerebral hemisphere. (0-4.5) Question 1 CRITERIA/20 HD 17 - 20 D 15 - 16.5 C 13.5 - 14.5 P 10 - 13 F ≤ 9.5 Demonstrates comprehensive and detailed knowledge of the pathogenesis of an ischaemic stroke related to a case study. Demonstrates the links between the pathogenesis of chronic obstructive pulmonary disease and the resulting structural and functional changes. Analyses information from a discerning selection of sources and synthesises in own words an accurate and clear explanation of the pathogenesis of an ischaemic stroke. The discussion is relevant to the case study. (8.5-10) Within the discussion the relationships between the pathogenesis of an ischaemic stroke and all structural and Analyses information from a discerning selection of sources and accurately explains the pathogenesis of an ischaemic stroke with discussion related to the case study. Some synthesis evident, but much of the discussion is paraphrased from single sources. (7.5-8.25) Within the discussion the relationships between the pathogenesis of an ischaemic stroke and most of the structural and Analyses information from relevant references. Describes the pathogenesis of an ischaemic stroke accurately with discussion mainly consisting of paraphrased information. Information may be incomplete.The discussion is generally related to the case study. (6.5-7.25) The structural and functional changes are described in the Using information from relevant references provides a basic description of the pathogenesis of an ischaemic stroke. There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow of the process. The discussion may be generalised rather than related to the case study. (5-6.25) A number of structural Using one or two relevant references gives a superficial description of the pathogenesis of an ischaemic stroke with a number of significant inaccuracies, repetition or lack of clarity. (2.5-4.5) Information predominantly copied or quoted from inappropriate sources such as non-authoritative web sites, Wikipedia, encyclopaedias or dictionaries, with little evidence of understanding. (0-2) Pathogenesis of ischaemis stroke not explained or explanation mostly inaccurate and lacking clarity. (0-2) Lists some structural and functional changes but most not accurately related to the pathogenic process. (1-4.5) QUESTION 2 CRITERIA/15 HD 13 - 15 D 11.5 - 12.5 C 10 - 11 P 7.5 - 9.5 F ≤ 7 Demonstrates comprehensive and detailed knowledge of the reasons for two clinical manifestations presented by the patient in the case study with clear links to the structural and functional changes identified. Analyses information from the case study and a discerning selection of sources and synthesises a response in own words explaining the reasons, with clear links to the structural and functional changes, for two clinical manifestations presented by the patient in the case study. Analyses information from the case study and a discerning selection of sources and provides clear and accurate reasons for two clinical manifestations presented by the patient in the case study. Evidence of some synthesis but information mostly paraphrased. Links to the structural and functional changes are mostly evident in the discussion. Analyses information from the case study and relevant references. Explains the reasons for two clinical manifestations presented by the patient in the case study with links to the structural changes generally being evident but at times may be incomplete. Provides a basic explanation for two clinical manifestations presented by the patient in the case study. Links to the structural and functional changes may lack clarity, contain minor errors or be incomplete. Provides a superficial description of two clinical manifestations but there are many significant inaccuracies and the links to the structural and functional changes are minimal and lack clarity. (3-7) Identifies clinical manifestations but the links to the structural and functional changes lack clarity, are mostly inaccurate or omitted. (1-2.5) Does not identify clinical manifestations presented by the patient in the case study. (0) QUESTION 3 CRITERIA/15 HD 13 - 15 D 11.5 - 12.5 C 10 - 11 P 7.5 - 9.5 P ≤ 7 Demonstrates comprehensive and detailed knowledge of the action of alteplase and Assasantin used in the treatment of the patient in the case study with clear links between the drug action and pathogenesis identified. Analyses information from the case study and a discerning selection of references and in own words synthesises a response explaining the rationales for the administration of alteplase and Assasantin to the patient with clear links to the pathogenesis discussed. Analyses information from the case study and a discerning selection of references and provides clear and accurate rationales for the administration of alteplase and Assasantin. Links between the action of the drugs and pathogenesis of ischaemic stroke are mostly evident. Analyses information from the case study and relevant references and explains the rationales for the administration alteplase and Assasantin. Drug actions are accurate but links to the pathogenesis of ischaemic stroke contain minor inaccuracies or are incomplete. Analysing information from relevant references provides basic rationales for the administration alteplase and Assasantin. Drug actions are accurate but links to the pathogenesis of ischaemic stroke lack clarity, contain inaccuracies or are only partially discussed. Reasons for the administration of alteplase and Assasantin are superficial or lack clarity with few or no links to the pathogenesis of ischaemic stroke. Information about drug action is mostly from a relevant source. (3-7) Drug actions have been mostly paraphrased or copied from non-authoritative sources with little evidence of understanding the reasons for their administration to the patient in the case study. There are no links between the drug action and pathogenesis of ischaemic stroke. (0-2.5) ACADEMIC WRITING CRITERIA/10 HD 8.5 - 10 D 7.5 - 8 C 6.5 - 7 P 5 - 6 F ≤ 4.5 Writes in a clear and succinct academic style. Uses correct grammar, spelling and punctuation. All information from sources is appropriately acknowledged correctly applying conventions of in-text referencing for APA style. A complete reference list is correctly formatted according to APA style. A minimum of five relevant, recent (within the past five years) including three journal articles is used. Evidence of use is clear and sources accurately cited. Writes in an advanced style exhibiting highly coherent and logical flow of ideas. Organisation of material exhibits an advanced level of clarity. No errors in spelling, grammar, punctuation or sentence construction. Referencing technique is flawless and follows APA convention, both in-text and in the reference list, Uses a discerning selection of references, beyond the minimum requirements. Evidence of cited sources clear and accurate, Writes clearly and succinctly with a coherent, logical flow of ideas exhibiting advanced clarity. No errors in spelling, punctuation, grammar or sentence construction. Referencing technique follows APA convention, but contains infrequent minor errors. Uses a discerning selection of references beyond the minimum requirements. Evidence of cited sources evident and accurate. Writes clearly and satisfactory use of language enables effective flow of ideas. Minor, infrequent errors in spelling, punctuation, grammar and sentence construction that do not impede flow of ideas. Referencing technique follows APA convention, but contains infrequent errors. Uses at least the minimum number of required references. Evidence of cited sources evident and accurate. Writing is reasonably clear, but limited use of language sometimes hinders the effective flow of ideas and meaning. Minor, frequent errors in spelling, punctuation, grammar and sentence construction that impede the flow of ideas. There may be frequent errors in APA referencing convention in in-text referencing and/or the reference list. Uses at least the minimum number or required references. Use of cited sources not always evident. Writes in an elementary style with very basic use of language and poor articulation of ideas. It may be verbose, convoluted or difficult to read. Organization of material and main points is unclear. The errors in spelling, punctuation, grammar and sentence construction impede meaning. There may be absence or incorrect use of APA referencing technique. Does not use the minimum number of required references, or uses predominantly inappropriate or non authoritative sources. Sources of information not correctly acknowledged.
Answered Same DayDec 23, 2021

Answer To: PATHOPHYSIOLOGICAL PROCESS TEMPLATE DISEASE: Iscahmic stroke DEFINITION: AETIOLOGY: PATHOGENESIS:...

Robert answered on Dec 23 2021
120 Votes
PATHOPHYSIOLOGICAL PROCESS TEMPLATE
Ischemic stroke
ABSTRACT
Stroke is a sudden loss of the neurological functioning of the brain cells which is due to the
insufficient supply of oxygen to the brain. But this is a treatable condition as to the degree of
effect to the degree of treatment. This is ischemic as its lack of sufficient blood flow to the
profuse cerebral tissue which is due to the interruption of fo
rward blood flow at any point in
the cerebral hemisphere which leads to irreversible neuronal damage.
Accordingly it is divided and can be analysed under following mechanisms;-
1. Thrombosis
2. Embolism
3. Systemic hypo perfusion
4. Arterial luminal obliteration
5. Venous congestion
Cerebral venous thrombosis can lead to vascular congestion, impairment of forward flow, and
eventually infarction.
The brain accounts for 2% of the body weight but 20% of the total oxygen
consumption and approx 70% of the metabolic demand in the brain is due to the sodium -
potassium ATPase pump that maintains the ionic gradient responsible for the neuronal
membrane potential, under ischemic stroke the mitochondrial production of ATP ceases and
intracellular ATP stores deplete within 2 minutes, cell membrane depolarize, leading to the
large influx of calcium and sodium and an efflux of potassium. Cell in the infarct core are
rapidly and irreversibly destroyed by lipolysis, proteolysis and disaggregation of
microtubules due to metabolic failure the penumbra – the zone of tissue between the infarct
core and normal brain experiences diminished blood flow but preserved cellular metabolism.
The goal of acute stroke therapies is to normalize perfusion and intervene in the cascade of
biochemical dysfunction to preserve cellular metabolism which are only done to normalize
perfusion and intervene in the cascade of biochemical dysfunction to preserve the maximal
amount of penumbral tissue.
INTRODUCTION
The stroke is referred to as the loss of brain and neurotic function due to insufficient supply of blood
to the brain. Where is ischemic means inadequate supply of blood to the brain (web resource –
internet stroke centre). Or this can also due to certain other conditions like diabetes, high
cholesterol, tobacco smoking. This stroke is due to thrombosis or obstruction of blood flow by clot
formation inside the vessels or due to other kind of tissue or fat deposition in different parts of the
body which leads to blockage
The cause is when the blood supply is interrupted to the brain; it may be blocked by a
blood clot or clump of fat. And as the patient is a chain smoker, then there are probabilities that the
parts of brain must have starved of oxygen and nutrients when blood vessels become blocked .These
damages the brain cells and begin to die. According to patients history he might have got cerebral
embolism (also known as embolic stroke ) (embolic stroke derived from ;embolism – American
stroke association /American heart associationUCM_310939_Article.jsp) ,in this the blood clot
from somewhere else in the body may be from heart or from any of the large arteries from where it is
supplied and travels to the brain and blocks the blood supply .And as mentioned the patient has
complained about speech problem and one side paralytic attack which very clearly indicated improper
brain control as brain controls each and every body actions including movements of hands ,legs ,body
parts ,speech ,vision and emotions .and even the patient’s age is 61 yrs which means at this age every
single body function should be controlled ,it may be the sugar ,blood pressure or the heart function .
For this the patient should maintain a regular routine exercise and diet. Smoking and alcohol
consumption should be avoided. And as there was a complain of hyper tension case 10 yrs ago then
there as chances of heart stroke to persist. Other studies indicate that smoking was an independent
risk factor of ischemic, and smokers with faster heart rate had the highest risk of ischemic stroke. A
system of categorisation of subtypes of ischemic stroke mainly based only on clinical features and
then reviewing the results of diagnostic tests, the test was developed for the trial of org 10172 in
acute stroke treatment (TOAST).
An ischemic stroke results when the cerebral blood flow to an area of the
brain which is interrupted ,which produces impaired energy metabolism and depolarisation of the cell
that leads to an accumulation of calcium ions in the intracellular space ,elevated lactate levels
,acidosis and production of free radicals. If the disruption is severe enough, cell death occurs.
Activation of the N-methyl D-aspartate receptor by an increase in glutamate leads to a cascade of
chemical reactions that ultimately leads to cell death. This process is modulated by polyamines,
glycine, magnesium which need to be delivered when the patient is carried to the hospital as a
neuroprotective agent (med scape /article/1161422-overview; author –Helmi L Lutsep, MD; chief
editor). Normal adult brain cerebral...
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