Module Two | Question
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Which TWO of the following individuals are most likely to have a stroke
in the next 1-2 years?
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a.
Anne, a 45 year-old White woman whose past medical history is
unremarkable. She is a non-smoker and has a total cholesterol of 190 mg/dL (HDL
70; LDL 120); her blood pressure is 110/80 mm Hg. She teaches aerobics at the local
gym and encourages her students to follow healthy diets. Both her parents are alive
and still active in community affairs; her mother has recently completed treatment
for breast cancer.
b.
Anne's father Henry, a 68 year-old White man who had what he
calls a "mini-stroke" 3 years ago. His doctor found that his left carotid artery
in his neck was nearly blocked, and he underwent carotid endarterectomy (surgical
removal of the obstructing atherosclerotic plaque). Since then he has been very
conscientious about carrying out his doctor's recommendations: following a low-fat
diet that contains many fruits and vegetables, losing 20 pounds, walking 2 miles
most days, and taking both blood pressure medications and a statin (a cholesterol-lowering
agent).
c.
George, a 45 year-old African American high school science teacher
diagnosed with high blood pressure 2 years ago. Initially George took his prescribed
blood pressure medications erratically. However, when a close friend suffered a
heart attack and nearly died, George began taking his medicine regularly. For the
past year, his blood pressure has been less than 130/85 mm Hg. George helps coach
the basketball team, and stays in shape by participating in defensive drills and
lifting weights. He is a non-smoker who tries to discourage members of his team
from smoking. Recently, George decided to cut out some of the fatty fried foods
he loves to eat, although he confesses that when he and his wife go to his mother's
house for holidays he indulges. His father died following a massive heart attack
at age 53.
d.
George's mother Sally, a 68 year-old African American woman
who hadn't been to a doctor in years but recently went to her local health clinic
at her son's urging. At the clinic, Sally's BMI (body mass index) was determined
to be 35, putting her in the "obese" category, and repeated blood glucose tests
indicated that she was diabetic. Her blood pressure was 170/90 mm Hg on her first
visit, and 160/90 on her second visit. Her total cholesterol was 260 mg/dL. Sally
isn't particularly concerned about her health, declaring that her son worries too
much about her and that she feels pretty good for someone her age. She is especially
proud of the fact that she has never smoked, and that she made sure George never
did either.
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What is the recommended blood pressure for adults who are not suffering from heart
failure, renal insufficiency or diabetes?
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In a few sentences, explain why atrial fibrillation greatly increases the risk of
ischemic stroke.
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Module Two | Answer to Question
Which ONE of the following factors puts a 40 year old man at the
GREATEST
risk of having a stroke?
Which
TWO of the following individuals are most likely to have a stroke
in the next 1-2 years?
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Your Answer
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Correct Answer: b and d
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a. Anne, a 45 year-old White woman
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a. Anne, a 45 year-old White woman
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b. Anne's father Henry , a 68 year-old White man
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b. Anne's father Henry , a 68 year-old White man
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c. George, a 45 year-old African American man
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c. George, a 45 year-old African American man
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d. George's mother Sally, a 68 year-old African American woman
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d. George's mother Sally, a 68 year-old African American woman
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What is the recommended blood pressure for adults who are not suffering from heart
failure, renal insufficiency or diabetes?
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Your Answer
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We Were Looking For:
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< 140/90 mm Hg. If this is a patient with heart failure, renal
insufficiency or diabetes, the recommended level is < 135/85 mm Hg.
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Patients with increased risk for myocardial infarction also have an increased risk
of stroke. What is the relationship between these problems? Select
all
correct answers.
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Your Answer
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Correct Answer: all
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a. Atherosclerosis is the prominent underlying pathology for both
stroke and MI.
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a. Atherosclerosis is the prominent underlying pathology for both stroke and MI.
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b. If thrombus forms on parts of the heart wall damaged by an MI,
it can break off and embolize the brain producing a stroke.
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b. If thrombus forms on parts of the heart wall damaged by an MI, it can break
off and embolize the brain producing a stroke.
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c. If damage to the heart wall leads to atrial fibrillation, this
increases the risk that thrombus will be formed in the left atrium, and that a piece
will leave the heart, and travel in the systemic circulation to the brain where
it can block a vessel and produce a stroke.
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c. If damage to the heart wall leads to atrial fibrillation, this increases the
risk that thrombus will be formed in the left atrium, and that a piece will leave
the heart, and travel in the systemic circulation to the brain where it can block
a vessel and produce a stroke.
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d. Hypertension causes damage to the walls of both coronary and
cerebral vessels.
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d. Hypertension causes damage to the walls of both coronary and cerebral vessels.
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e. Cigarette smoking causes changes in the blood such as increased
sticking together of platelets and faster clotting times that would promote clot
formation in both coronary and cerebral vessels.
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e. Cigarette smoking causes changes in the blood such as increased sticking together
of platelets and faster clotting times that would promote clot formation in both
coronary and cerebral vessels.
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What is the currently recommended level of physical activity that provides the most
effective reduction of stroke risk (assume that the patient has no complicating
medical conditions)?
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Your Answer
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Correct Answer: c
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a. Moderate-to-brisk exercise for 15 minutes at least 3 times a
week..
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a. Moderate-to-brisk exercise for 15 minutes at least 3 times a week.
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b. Moderate-to-brisk exercise for at least 30 minutes 2 times a
week.
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b. Moderate-to-brisk exercise for at least 30 minutes 2 times a week.
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c. Moderate-to-brisk exercise for 30 minutes at least 3 times a
week.
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c. Moderate-to-brisk exercise for 30 minutes at least 3 times a week.
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d. Light-to-moderate exercise for 15 minutes 2 times a week.
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d. Light-to-moderate exercise for 15 minutes 2 times a week.
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e. Light-to-moderate exercise for 15 minutes 3 times a week.
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e. Light-to-moderate exercise for 15 minutes 3 times a week.
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In a few sentences, explain why atrial fibrillation greatly increases the risk of
ischemic stroke.
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Your Answer
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We Were Looking For:
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When the heart is in atrial fibrillation it does not eject blood effectively. This
means that blood can pool and stagnate within the left atrium, greatly increasing
the chance that a thrombus will form. A thrombus in the left atrium can break up,
pass into the left ventricle, and from there enter the systemic circulation and
travel anywhere in the body, including the brain. Such a cardiac embolus can occlude
arteries, sometimes producing a TIA (if the occlusion is brief), but more commonly
a stroke (if the occlusion lasts long enough to produce permanent brain injury).
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What specific group in the United States has the highest death rate from stroke?
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Your Answer
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Correct Answer: b
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a. African American men and women living in the Northeast
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a. African American men and women living in the Northeast
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b. African American men and women living in the Southeast
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b. African American men and women living in the Southeast
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c. Mexican American women living in the Southeast
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c. Mexican American women living in the Southeast
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d. Senior men and women living in the Northeast
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d. Senior men and women living in the Northeast
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e. African American men living in the Northeast
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e. African American men living in the Northeast
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f. Non-Hispanic white men and women living in the Southeast
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f. Non-Hispanic white men and women living in the Southeast
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How much does having a TIA increase your risk of having a stroke compared to someone
of the same age and gender who has
not had a TIA?
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Your Answer
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Correct Answer: b
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a. A TIA approximately doubles the risk of stroke
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a. A TIA approximately doubles the risk of stroke
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b. A TIA increases the risk of stroke approximately 10 times
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b. A TIA increases the risk of stroke approximately 10 times
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c. A TIA does not alter the risk of stroke
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c. A TIA does not alter the risk of stroke
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d. After treatment for the underlying causes, a TIA does not alter
the risk of stroke
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d. After treatment for the underlying causes, a TIA does not alter the risk of
stroke
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End of Self Test
Module 2