1. Why do Robert’s symptoms increase in the first two days? Why is he given glucocorticoids?

Robert’ssymptoms increase over the first two days due to the fact that theblockage in the carotid artery is still healing leading to a furtherlack of oxygen in the brain which increases the symptoms of thestroke. Glucocorticoids are chemicals that help stop inflammation inmany parts of the body. A cerebrovascular accident can cause aninflammation in the carotid artery of the brain due to blockage by ablood clot. Glucocorticoids help to reduce this inflammation.

  1. Based on the fact that Robert was not given tPA, what is the most likely cause of CVA?

Cerebrovasculardisorder was most likely caused by the widening and weakening ofblood vessels in the brain leading to bleeding of the brain

  1. Which side of the brain was involved in this CVA? How do you know? What does a flaccid mean and will Robert’s extremities remain flaccid if he does not gain the ability to move them?

Theleft side of the brain was involved in the CVA because Robertexperienced aphasia (a problem in expressing himself or speech).Aphasia is usually caused by damage to the left side of the brainwhich is responsible for speech. A flaccid means a weak, soft and lowmuscle tone associated with the early symptoms of a stroke. Theflaccid stage of the stroke treatment may linger a while but finallygoes away.

  1. There will be a team approach to Robert’s recovery. Describe the role of the physical therapist, occupational therapist, speech-language pathologist and social worker


Themain occupation of the physical therapist is to teach the patient howsit, stand and walk the physical therapist will undertake to try andmake the patient stand up and move through performing variousexercises. They also educate the family of the patient on the ways ofpositioning the patients.


Workstowards eradicating the physical cognitive and emotional stressesbrought about by a stroke he/she works with the patient to find waysof working with one side of the body when the other is paralyzed andprovides equipment that makes work easier for the patient


Thesocial worker works hand in hand with the patient, the family and therehabilitation crew in order to realize the goals of rehabilitation.He/She manages costs and talks to the family on the rehabilitationstrategies.

Speechlanguage pathologist.

Thespeech language pathologist works towards improving the speech of thepatient affected by a CVA. Some of the practices that he will doincluding encouraging the patient to pronounce letters and move on towords he also explains t the family techniques through which thepatient can improve his speech.


  1. What is Lynn’s likely diagnosis? Which of the findings of the medical test support this diagnosis? Which of the findings is most conclusive for this disease?

Lynn’slikely diagnosis is multiple sclerosis a disease that affects thecentral nervous system by a progressive autoimmune attack on the CNS(Lezzoni, 2010). The MRI test that showed the presence of 4-5 plaquesin the spinal cord is the most conclusive test for this disease sincethe disease causes the immune system to attack the CNS leaving scartissue known as plaques. The finding of plaques in the spinal cordsupports this diagnosis.

  1. What causes this disease? What happens to the nerves in this disease? Are there cognitive defects.

Multiplesclerosis is caused by an autoimmune disorder affecting the centralnervous system. The immune system of the body attacks the nervesmyelin. This attack of the nerve’s myelin causes the creation ofscar tissue which prevents the movement of nerve impulses to thebrain or through the central nervous system. There may occurcognitive defects such as blurred vision.

  1. Does it affect men or women more often? Is it common?

Multiplesclerosis affects twice or thrice as many women as men. It is howevernot common affecting around 0.1% of the population (Gould, 516)

  1. Why is Lynn given glucocorticoids to take during exacerbations, what will they do for her?

Glucocorticoidsare medicines that are used with a lot of casas of autoimmunedisorders. They help reduce inflammation in the parts of the bodywhere attack of body tissue by white blood cells has caused damage.Glucocorticoids will reduce this inflammation.

  1. How will this disease progress over the next few years? What is the prognosis?

Theprognosis of multiple sclerosis may take different forms depending onthe course of MS Lynn has. Relapsing remitting MS will cause Lynn tohave clearly defined attacks followed by a decreasing intensity ofattack and finally recovery (Lezzoni, 2010). Another course ofmultiple sclerosis is the primary progressive MS in which the diseasecauses the function of the central nervous system to worsen slowlyover a period of time. MS may also take the secondary progressive MSin which Lynn’s condition worsens steadily with or without periodsof increasing severe manifestations of symptoms or recoveries fromthese symptoms.

Thefinal course is the progressively-worsening MS in which Lynn’sneurological functions worsens constantly from the start with clearexacerbations.


Lezzoni,L. I. (2010). Multiple sclerosis. Santa Barbara, Calif: Greenwood.