Cerebrovascular disease and clinical history

Question 1

Neurologic deficit with no lasting effects completely resolving within 24 hours is a

Answer 1

TIA

Question 2

A TIA is usually embolic and most common from the

Answer 2

Heart

Question 3

This last longer than a TIA but completely resolves within 72 hours

Answer 3

RIND

Question 4

This is a permanent neurologic deficit

Answer 4

CVA

Question 5

This is ischemia affecting posterior circulation

Answer 5

VBI

Question 6

What is the most common reason for cerebrovascular insufficiency

Answer 6

Ischemia

Question 7

Bleeding from hypertension, ruptured aneurysm, and trauma is called a

Answer 7

Hemorrhage

Question 8

What is the most common arterial disease

Answer 8

Atherosclerosis

Question 9

What is the most contributing factor to arterial disease

Answer 9

Smoking

Question 10

Thickening and hardening of intima and medial layers describes

Answer 10

Atherosclerosis

Question 11

Where is atherosclerosis most commonly found at

Answer 11

Bifurcations and proximal vessels

Question 12

A thin hypoechoic layer describes what type of plaque

Answer 12

Fatty streak

Question 13

Lipids with collagen and fibrous material describes what type of plaque

Answer 13

Fibrous plaque

Question 14

What are 2 other names for fibrous plaque

Answer 14

1) smooth
2) homogeneous

Question 15

Soft fibrous plaque will look like

a) hyperechoic
b) hypoechoic

Answer 15

b) hypoechoic

Question 16

Hard/ dense fibrous plaque will be

Answer 16

echogenic

Question 17

Fibrous plaque mixed with calcium and debris that is complex or heterogenous describes what type of plaque

Answer 17

Complicated lesion

Question 18

This type of plaque is completely hyperechoic with posterior shadowing

Answer 18

Calcified

Question 19

This type of plaque is seen as a oval sonolucent area within the plaque that no flow is seen inside and is considered to be an unstable lesion

Answer 19

Intraplaque hemorrage

Question 19

This type of plaque has a crater like deterioration where flow is seen inside and is considered unstable and may embolize or rupture

Answer 19

Ulcerative

Question 19

Where is the most common source for an embolism

Answer 19

Heart

Question 19

Thrombosis may come from what 3 things

Answer 19

1) plaque
2) trauma
3) dissection

Question 20

What type of plaque is cholesterol crystals from the carotid that travel to the retina of the eye

Answer 20

Hollenhorst plaque

Question 21

An acute total occlusion is considered a

Answer 21

stroke

Question 22

What is the most common cause of a pulsatile neck mass

Answer 22

Tortuous vessels

Question 23

Where is a carotid body tumor found

Answer 23

Between ICA and ECA

Question 24

What vessel feeds a carotid body tumor

Answer 24

ECA

Question 25

A ________ is most commonly found by trauma

Answer 25

Dissection

Question 26

What is an overgrowth of collagen in the medial layer called

Answer 26

Fibromuscular Dysplasia

Question 27

What is usually in younger women and is found in the mid to distal ICA

Answer 27

Fibromuscular dysplasia

Question 28

A fibromuscular dysplasia is most likely found on what

Answer 28

an angiogram

Question 29

Intimal thickening caused by rapid reproduction of smooth muscle describes

Answer 29

Neointimal hyperplasia

Question 30

________ _________ is seen as a hypoechoic lining inside of a vessel

Answer 30

Neointimal hyperplasia

Question 31

What happens 6-24 months post endarterectomy

Answer 31

Neointimal hyperplasia

Question 32

______ indicates which side or hemisphere is affected

Answer 32

Lateralizing

Question 33

Anterior circulation feeds which hemispheres

Answer 33

RT or Lt

Question 34

The right ICA goes to which hemisphere

Answer 34

Rt

Question 35

The left ICA goes to which hemisphere

Answer 35

Left

Question 36

If symptoms are see in a side of the body it means the problem is where

Answer 36

on the other side

Question 37

The right hemisphere controls what side of the body

Answer 37

Left

Question 38

Vessel to the brain= a) same b) opposite

Answer 38

a) same

Question 39

Vessel to the body= a) same b) opposite

Answer 39

b) opposite

Question 40

_________is weakness or paralysis

Answer 40

Paresis

Question 41

_______/ anesthesia has tingling and numbness

Answer 41

parestheisa

Question 42

Impaired speech is called what

Answer 42

Dysphasia

Question 43

The inability to speak is called

Answer 43

Aphasia

Question 44

During dysphasia what hemisphere is affected

Answer 44

Dominant

Question 45

A right handed person is what hemisphere dominant

Answer 45

Left

Question 46

Temporary blindness in 1 eye describes

Answer 46

Amaurosis fugax

Question 47

Amaurosis fugax comes for what artery

Answer 47

Ophthalmic artery ipsilateral ICA

Question 48

Behavior changes come from what artery

Answer 48

Right MCA

Question 49

Loss of vision in half of the visual field in both eyes describes

Answer 49

Homonymous hemianopia

Question 50

Stroke of the cerebral cortex is what

Answer 50

Homonymous hemianopia

Question 51

What vessel affects the entire side of the body, amaurosis fugax, and speech a) ICA b) MCA c) ACA

Answer 51

a) ICA

Question 52

What vessel affects the face, arm, speech, and behavior a) ICA b) MCA c) ACA

Answer 52

b) MCA

Question 53

What vessel affects the leg, incontinence, and loss of coordination a) ICA b) MCA c) ACA

Answer 53

c) ACA

Question 54

What vessel is the most common location for disease causing a stroke

Answer 54

MCA

Question 55

1) unilateral paresis 2) unilateral paresthesia/anesthesia 3) Dysphasia 4) Amaurosis fugax 5) Homonymous hemianopia all of these symptoms come from which circulation

Answer 55

Anterior

Question 56

Non- lateralizing, non sides known, and VBI are apart of which circulation

Answer 56

Posterior

Question 57

1) vertigo 2) ataxia 3) bilateral blurry vision 4) diplopia 5) bilateral paresthesia 6) drop attack All of these symptoms come from which circulation

Answer 57

Posterior

Question 58

The sensation of moving/spinning around describes

Answer 58

Vertigo

Question 59

Lack of coordination describes

Answer 59

Ataxia

Question 60

What is dipolopia

Answer 60

Double vision

Question 61

Falling to the ground without losing consciousness describes

Answer 61

Drop attack

Question 62

____ ______= location unknown and tells us nothing

Answer 62

Non-localizing

Question 63

A TIA of left amaurosis fugax is caused by a blockage in what vessel a) left ICA b) right ICA c) left ECA d) Left CCA

Answer 63

a) left ICA - Left eye = Left ICA - amaurosis fugax always goes with the same side ICA

Question 64

Which plaque has erosion of the fibrous cap a) calcific b) intraplaque hemorrhage c) ulcerative d) irregular

Answer 64

c) ulcerative

Question 65

What would cause a right hemispheric infarction a) left ECA occlusion b) right ECA occlusion c) left ICA occlusion d) right ICA occlusion

Answer 65

d) right ICA occlusion The right ICA supplies the right hemisphere with blood. So if that is the location of the stroke or infarction, the same sided vessels could be responsible.

Question 66

A patient presents with sudden onset syncope, aphasia, and right face and arm paresis. Obstruction disease in which of the following is most likely responsible a) right MCA b) undertiminable c) Left ACA d) Left MCA

Answer 66

d) Left MCA

Question 67

What clinical finding is consistent with vertebrobasilar insufficiency a) amaurosis fugax b) syncope c) dysphasia d) diplopia

Answer 67

d) diplopia indications of VBI include: vertigo, ataxia, drop attacks, bilateral visual disturbances, and bilateral body symptoms. Speech and unilateral eye symptoms indicate anterior circulation -syncope is non-localizing and doesnt mean anything

Question 68

What 4 arteries are apart of the anterior circulation and supply blood to the brain cerebral hemispheres?

Answer 68

1) ICA 2) MCA 3) ACA 4) Anterior communicating arteries

Question 69

What 4 arteries are apart of the posterior circulation and supply blood to the brain stem, cerebellum, and occipital lobes?

Answer 69

1) Vertebral 2) Basilar 3) PCA 4) Posterior communicating arteries

Question 70

A high resistance flow pattern in the distal portion of the ICA suggests which of the following conditions? a) Proximal CCA disease b) Proximal ICA disease c) Intracranial AV fistula d) Severe distal ICA stenosis

Answer 70

d) Severe distal ICA stenosis

Question 71

A patient presents with the classic cerebrovascular symptom of the left amaurosis fugax. Of the choices below, what is the most likely cause? a) Atheroemboli from the left ICA b) Atheroemboli from the right ICA c) Occlusion of the left vertebral artery d) Occlusion of the left ICA

Answer 71

a) Atheroemboli from the left ICA

Question 72

Which of the following is a non-atherosclerotic disease involving the mid segment of the ICA and found predominately in females? a) Takayasu arteritis b) Fibromuscular dysplasia c) Arteriosclerosis d) Scleroderma

Answer 72

b) Fibromuscular dysplasia

Question 73

Which of the following is the angiographic measurement method recommended by the SRU consensus conference of 2003, also known as the "NASCET" method? a) The estimated bulb diameter compared to the residual ICA lumen b) The diameter of the CCA compared to the residual ICA lumen c) The distal ICA lumen compared to the residual ICA lumen d) The distal ICA diameter compared to the CCA diameter

Answer 73

c) The distal ICA lumen compared to the residual ICA lumen