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stroke. SCHISOPHRENIA
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stroke
Phonetic exercise: nervous system [‘n 
: və s ‘sistim], neurological [, njuə rə ’l 
d3ikl], encephalitis [, ensə fə ‘laitis], meningitis [, menin’d3aitis], stroke [strə uk], transient [‘træ nziə nt], ischemic [is’ki: mik], hemorrhage [‘hemə rid3], hemorrhagic [, hemə ’ræ d3ik], accident [‘æ ksidə nt], attack [ə ‘tæ k], tumours [‘tju: mə z], polio [‘pə uliə u], paralysis [pə ‘ræ lə sis], ultrasound [‘Λ ltrə saund], magnetic [mæ g’netik]; resonance [‘rezə nə ns], imaging [‘imid3iŋ ], thrombus [‘θ r mbə s], thrombosis [θ r m’bə usis], interruption [, intə ’rΛ p∫ n], obstruction [ə b’strΛ k∫ n], cholesterol [kə ‘lestə r l], supply [sə ‘plai], area [‘eə riə ], hemiplegia [, hemi’pli: d3iə ], numb [nΛ m], numbness [‘nΛ mnə s], obesity [ə u’bi: sə ti; ə u’bi: siti], vibratory [‘vaibrə tə ri], dysphasia [dis’feiziə ], aphasia [ə ’feiziə, æ ’feiziə ], vertigo [‘və: tigə u], consciousness [‘k n∫ ə snə s], arteriography [a:, tiə ri’ grə fi], electrocardiography [, ilektrok 
di‘ grə fi], ultrasound [‘Λ ltrə saund], angioplasty [‘æ nd3i , plæ sti]
Make a report on stroke according to the plan below:
Definition: a cerebrovascular accident (CVA), the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain.
Definition of the World Health Organization: a " neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours".
Classification: two major categories: ischemic stroke and hemorrhagic stroke.
Causes of ischemic strokes: interruption of the blood supply. Blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. In an ischemic stroke, there are four reasons why this might happen: thrombosis (obstruction of a blood vessel by a blood clot forming locally), embolism (obstruction due to an embolus from elsewhere in the body), systemic hypoperfusion (general decrease in blood supply, e. g. in shock), venous thrombosis.
Cause of hemorrhagic strokes: rupture of a blood vessel or an abnormal vascular structure.
Epidemiology: Stroke could soon be the most common cause of death worldwide. Stroke is currently the second leading cause of death in the Western world, ranking after heart disease and before cancer, and causes 10% of deaths worldwide. 87% of strokes are caused by ischemia, and the remainder by hemorrhage.
Risk factors: high blood pressure, atrial fibrillation, high blood cholesterol levels, diabetes, cigarette smoking (active and passive), heavy alcohol consumption, drug use, lack of physical activity, obesity and unhealthy diet.
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Symptoms, signs, clinical manifestations, clinical features: Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further.
The symptoms: sudden-onset face weakness, arm drift (e. g. if a person, when asked to raise both arms, involuntarily lets one arm drift downward), abnormal speech, hemiplegia and muscle weakness of the face, numbness, reduction in sensory or vibratory sensation, altered smell, taste, hearing, or vision (total or partial), drooping of eyelids (ptosis) and weakness of ocular muscles, decreased reflexes: swallowing, pupil reactivity to light, balance problems, altered breathing and heart rate, inability to turn head to one side, weakness in the tongue (inability to protrude and/or move from side to side), aphasia (inability to speak or understand language), apraxia (altered voluntary movements), visual field defect, memory deficits (involvement of temporal lobe), disorganized thinking, confusion, altered movement coordination, vertigo and or disequilibrium; associated symptoms: loss of consciousness, headache, and vomiting, etc.
Evaluation: History: a personal medical history, a medication history, a family history, a social history, an occupational history, an environmental history, a neurological status history, an alcohol consumption history, a tobacco consumption history, etc.
Physical examination: observation, percussion, palpation, auscultation, neurological examination.
Instrumental evaluation: CT scans or MRI scans, Doppler ultrasound, and arteriography; no commonly used blood tests for the stroke diagnosis itself, though blood tests may be of help in finding out the likely cause of stroke; an electrocardiogram (ECG) and echocardiogram (to identify arrhythmias and resultant clots in the heart which may spread to the brain vessels through the bloodstream); a Holter monitor study to identify intermittent arrhythmias, an angiogram of the cerebral vasculature (if a bleed is thought to have originated from an aneurysm or arteriovenous malformation), etc.
Treatment: admittion to a " stroke unit", a ward or dedicated area in hospital staffed by nurses and therapists with experience in stroke treatment.
Treatment of ischemic stroke: thrombolysis, or thrombectomy; treatment with medications such as aspirin, clopidogrel and dipyridamole to prevent platelets from aggregating; control of blood sugars, ensuring the patient has adequate oxygenation and adequate intravenous fluids; intra-artial fibrinolysis, where a catherter is passed up an artery into the brain and the medication is injected at the site of thrombosis; mechanical thrombectomy; angioplasty and stenting; therapeutic hypothermia; secondary prevention of ischemic stroke: anticoagulation. Patients may be positioned with their heads flat on the stretcher, rather than sitting up, to increase blood flow to the brain. It is common for the blood pressure to be elevated immediately following a stroke.
Treatment of hemorrhagic stroke: anticoagulants and antithrombotics, oxygenation
Care and rehabilitation: the cornerstones of the rehabilitation process: physiotherapy and occupational therapy; a wheelchair, walkers, canes, and orthoses, devices which support or correct the function of a limb or the torso; speech and language therapy, good nursing care, etc.
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SCHISOPHRENIA
Phonetic exercise: schizophrenia [, skitsə u’fri: niə ], serious [’siə riə s], average [‘æ vrid3], environmental [in, vaiə rə ’mentl], urban [‘ə: bə n], racial [‘rei∫ l], experiences [ik’spiə riə nsiz], abuse [(n) ə ’bju: s, (v) ə ’bju: z], psychosis [sai’kə usis], hallucinations [hə, lu: si’nei∫ nz], delusions [di’lu: 3nz], bizarre [bi’za: ], strange [‘strein3], persecutory [‘pə: sikju: tə ri], severe [si’viə ], isolation [, aisə ’lei∫ n], withdrawal [wið ’dr : ə l], auditory [‘ : ditə ri], chaotic [kei‘ tik], behavior [bi‘heivjə ], behavioral [bi‘heivjə rə l], abnormalities [, æ bn : ‘mæ lə tiz], catatonic [, kæ tə ’t nik], psychotherapy [, saikə u‘θ erə pi], cognitive [‘k gnə tiv]
Make a report on schizophrenia according to the plan below:
Definition: a serious mental illness characterized by a disintegration of the process of thinking, of contact with reality, and of emotional responsiveness.
Mortality: a higher than average suicide rate associated with schizophrenia.
Epidemiology: Schizophrenia occurs equally in males and females.
Causes and risk factors: genetic and environmental factors, prenatal factors, urban environment, poverty, racial discrimination, family dysfunction, unemployment or poor housing conditions, childhood experiences of abuse or trauma, unsupportive dysfunctional relationships, alcohol-induced psychosis, etc.
Symptoms, signs, clinical manifestations, clinical features: hallucinations (most commonly hearing voices), delusions (often bizarre or persecutory in nature), and disorganized thinking and speech, word salad in severe cases, lack of responsiveness or motivation, social isolation, social withdrawal, irritability and dysphoria in the prodromal period, psychosis, auditory hallucinations, poverty of speech (alogia), inability to experience pleasure (anhedonia), lack of desire to form relationships (asociality), and lack of motivation (avolition). chaotic speech, thought, and behavior.
Evaluation: History: a personal medical history, a medication history, a family history, a family history of schizophrenia, a social history, an occupational history, an environmental history, a neurological status history, a psychiatric history, a symptom profile history, a history of self-reported experiences of the person, a history of abnormalities in behavior reported by family members, friends or co-workers, etc.
Physical examination: observation, percussion, palpation, auscultation, neurological examination, some forms of mental status examination, etc.
Analysis of characteristic symptoms: delusions; hallucinations; disorganized speech, which is a manifestation of formal thought disorder; disorganized behavior (e. g. dressing inappropriately, crying frequently) or catatonic behaviour; lack or decline in emotional response, lack or decline in speech, lack or decline in motivation; social/occupational dysfunction; duration: continuous signs of the disturbance persist for at least six months.
Management: antipsychotic medication s: Risperidone (trade name Risperdal), Clozapine Chlorpromazine; hospitalization in case of severe episodes of schizophrenia; drop-in centers; psychological and social interventions: visits from members of a community mental health team; supported employment, patient-led support groups; psychotherapy; cognitive behavioral therapy; family therapy or education, which addresses the whole family system of an individual with a diagnosis of schizophrenia; other treatments: electroconvulsive therapy, regular exercise, etc.
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