OSCE PREFINAL EXAMINATION

1. 𝐖𝐡𝐲 𝐛𝐫𝐨𝐜𝐚𝐬 𝐚𝐫𝐞𝐬 𝐢𝐬 𝐚𝐟𝐟𝐞𝐜𝐭𝐞𝐝 ?

• Broca's area is located in the frontal lobe of the brain, specifically in the left hemisphere. It's situated in the posterior part of the frontal gyrus, which is responsible for speech production and language processing. It is supplied by the middle cerebral artery. So in MCA infarct it can affect this brocas area and can lead to difficulty in speech

2. 𝐖𝐡𝐚𝐭 𝐚𝐫𝐞 𝐭𝐡𝐞 𝐬𝐞𝐧𝐬𝐨𝐫𝐲 𝐚𝐧𝐝 𝐦𝐨𝐭𝐨𝐫 𝐚𝐫𝐞𝐚𝐬 𝐬𝐮𝐩𝐥𝐥𝐢𝐞𝐝 𝐛𝐲 𝐌𝐂𝐀 𝐚𝐧𝐝 𝐰𝐡𝐢𝐜𝐡 𝐚𝐫𝐞 𝐚𝐟𝐟𝐞𝐜𝐭𝐞𝐝 𝐢𝐧 𝐭𝐡𝐢𝐬 𝐜𝐨𝐧𝐝𝐢𝐭𝐢𝐨𝐧? 

• The middle cerebral artery (MCA) primarily supplies blood to various regions of the cerebral cortex. Sensory and motor areas supplied by the MCA include parts of the face, upper and lower limbs, and areas involved in sensory and motor functions. The specific regions can vary among individuals, but generally, the MCA contributes to the blood supply of the lateral convexity of the cerebral hemisphere. This includes the precentral gyrus (primary motor cortex) and the postcentral gyrus (primary somatosensory cortex). Damage to the MCA can lead to motor and sensory deficits on the contralateral side of the body.

3. 𝐖𝐡𝐚𝐭 𝐢𝐬 𝐭𝐡𝐞 𝐫𝐨𝐥𝐞 𝐨𝐟 𝐚𝐬𝐩𝐢𝐫𝐢𝐧 𝐚𝐧𝐝 𝐜𝐥𝐨𝐩𝐢𝐝𝐨𝐠𝐫𝐞𝐥 𝐢𝐧 𝐜𝐞𝐫𝐞𝐛𝐫𝐨𝐯𝐚𝐬𝐜𝐮𝐥𝐚𝐫 𝐚𝐜𝐜𝐢𝐝𝐞𝐧𝐭?

• Aspirin and clopidogrel are antiplatelet medications commonly used in the management of cerebrovascular accidents (CVAs), also known as strokes. They help prevent blood clot formation by inhibiting platelet aggregation, which is crucial in reducing the risk of further vascular events.

"Aspirin" works by blocking the action of an enzyme called cyclooxygenase, thereby inhibiting the production of thromboxane A2, a substance that promotes platelet aggregation. Clopidogrel, on the other hand, is a platelet inhibitor that blocks the activation of platelets by preventing specific receptors from binding.

4. 𝐑𝐨𝐥𝐞 𝐨𝐟 𝐝𝐮𝐚𝐥 𝐚𝐧𝐭𝐢𝐩𝐥𝐚𝐭𝐞𝐥𝐞𝐭 𝐭𝐡𝐞𝐫𝐚𝐩𝐲 𝐢𝐧 𝐜𝐞𝐫𝐞𝐛𝐫𝐨𝐯𝐚𝐬𝐜𝐮𝐥𝐚𝐫 𝐚𝐜𝐜𝐢𝐝𝐞𝐧𝐭?

• Dual antiplatelet therapy (DAPT) involves the use of two antiplatelet medications concurrently, commonly aspirin and clopidogrel, to further reduce the risk of recurrent cerebrovascular accidents (CVAs). The rationale behind DAPT is to enhance the antiplatelet effect and inhibit different pathways involved in platelet activation and aggregation.

• The combination of aspirin and clopidogrel is often prescribed after certain types of ischemic strokes or transient ischemic attacks (TIAs). This approach is particularly relevant in cases of acute coronary syndrome or high-risk conditions, where the benefit of preventing blood clot formation outweighs the potential risks associated with dual therapy.

• The duration of dual antiplatelet therapy is also carefully determined based on the specific circumstances of each patient.

5. 𝐑𝐨𝐥𝐞 𝐨𝐟 𝐬𝐭𝐚𝐭𝐢𝐧𝐬 𝐢𝐧 𝐂𝐕𝐀?

• Statins play a significant role in the management of cerebrovascular accidents (CVAs), particularly ischemic strokes. Ischemic strokes are often caused by atherosclerosis, a condition characterized by the buildup of cholesterol and fatty deposits in the arteries supplying blood to the brain. Statins are a class of medications that primarily target cholesterol levels in the blood.

𝐋𝐄𝐀𝐑𝐍𝐈𝐍𝐆 𝐏𝐎𝐈𝐍𝐓𝐒 :-

• I learnt the Importance of proper history taking as it may show up with many differential diagnosis and confirming one from them .

• Importance of early diagnosis 

As in this case due to their delay the situation got worsen. So early treatment is important.

•  I learnt how much is it important to educate patients family members to look after their geriatric patient and not neglecting any of her condition  thereafter.

• I learnt about the dosage of the medications and their side effects.