22 - 70 yo M with unilateral weakness

Question 1

• if given within ____ hours, IV TPA has proven benefit in salvaging hypoxic brain tissue
• intra-arterial therapy improves functional outcomes if it can be given within ____ hours

Answer 1

• 3

- 6

Question 2

• spatial and perceptual deficits
• misjudging distances
• reading books upside down
• hemineglect
• denial of stroke disability

Answer 2

right MCA (right parietal stroke)

in a right handed individual

Question 3

expressive and receptive aphasia

Answer 3

left MCA stroke

Question 4

BNP is a polypeptide released by _____________ in response to _______________

Answer 4

• cardiac ventricles

- ventricular volume expansion and pressure overload

Question 5

what are the therapies and indications for prevention of first stroke?

Answer 5

• warfarin: all pts with nonvalvular AF at moderate and high risk
• antiplatelet ASA: low and moderate risk AF
• ASA and clopidogrel: for high risk pts unsuitable for anticoagulation; more protection than ASA alone but with increased risk of major bleeding

Question 6

what are the therapies and indications for prevention of recurrent stroke?

Answer 6

• warfarin: for pts with ischemic stroke or TIA with paroxysmal or permanent AF
• ASA alone: for pts unable to take anticoagulants

Question 7

what are the medications indicated for prevention of first and recurrent stroke?

Answer 7

• warfarin
• apixaban
• dabigatran
• rivaroxaban

Question 8

what are the criteria for CHA2DS2-VASC?

Answer 8

CHF 
HTN 
Age (65-74: 1 pts; 75 and over: 2 pts) 
DM 
Stroke Hx (2 pts if yes) 
Sex (female 1pt) 
VASC: vascular disease hx 

1 pt: low-moderate - consider antiplatelet or anticoagulation
2 pts or more: moderate-high risk anticoagulate