Cerebrovascular disease and clinical history Flashcards

1
Q

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

A

TIA

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2
Q

A TIA is usually embolic and most common from the

A

Heart

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3
Q

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

A

RIND

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4
Q

This is a permanent neurologic deficit

A

CVA

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5
Q

This is ischemia affecting posterior circulation

A

VBI

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6
Q

What is the most common reason for cerebrovascular insufficiency

A

Ischemia

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7
Q

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

A

Hemorrhage

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8
Q

What is the most common arterial disease

A

Atherosclerosis

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9
Q

What is the most contributing factor to arterial disease

A

Smoking

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10
Q

Thickening and hardening of intima and medial layers describes

A

Atherosclerosis

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11
Q

Where is atherosclerosis most commonly found at

A

Bifurcations and proximal vessels

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12
Q

A thin hypoechoic layer describes what type of plaque

A

Fatty streak

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13
Q

Lipids with collagen and fibrous material describes what type of plaque

A

Fibrous plaque

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14
Q

What are 2 other names for fibrous plaque

A

1) smooth
2) homogeneous

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15
Q

Soft fibrous plaque will look like

a) hyperechoic
b) hypoechoic

A

b) hypoechoic

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16
Q

Hard/ dense fibrous plaque will be

A

echogenic

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17
Q

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

A

Complicated lesion

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18
Q

This type of plaque is completely hyperechoic with posterior shadowing

A

Calcified

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19
Q

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

A

Intraplaque hemorrage

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19
Q

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

A

Ulcerative

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19
Q

Where is the most common source for an embolism

A

Heart

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19
Q

Thrombosis may come from what 3 things

A

1) plaque
2) trauma
3) dissection

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20
Q

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

A

Hollenhorst plaque

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21
Q

An acute total occlusion is considered a

A

stroke

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22
Q

What is the most common cause of a pulsatile neck mass

A

Tortuous vessels

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23
Q

Where is a carotid body tumor found

A

Between ICA and ECA

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24
Q

What vessel feeds a carotid body tumor

A

ECA

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25
Q

A ________ is most commonly found by trauma

A

Dissection

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26
Q

What is an overgrowth of collagen in the medial layer called

A

Fibromuscular Dysplasia

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27
Q

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

A

Fibromuscular dysplasia

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28
Q

A fibromuscular dysplasia is most likely found on what

A

an angiogram

29
Q

Intimal thickening caused by rapid reproduction of smooth muscle describes

A

Neointimal hyperplasia

30
Q

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

A

Neointimal hyperplasia

31
Q

What happens 6-24 months post endarterectomy

A

Neointimal hyperplasia

32
Q

______ indicates which side or hemisphere is affected

A

Lateralizing

33
Q

Anterior circulation feeds which hemispheres

A

RT or Lt

34
Q

The right ICA goes to which hemisphere

A

Rt

35
Q

The left ICA goes to which hemisphere

A

Left

36
Q

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

A

on the other side

37
Q

The right hemisphere controls what side of the body

A

Left

38
Q

Vessel to the brain=

a) same
b) opposite

A

a) same

39
Q

Vessel to the body=

a) same
b) opposite

A

b) opposite

40
Q

_________is weakness or paralysis

A

Paresis

41
Q

_______/ anesthesia has tingling and numbness

A

parestheisa

42
Q

Impaired speech is called what

A

Dysphasia

43
Q

The inability to speak is called

A

Aphasia

44
Q

During dysphasia what hemisphere is affected

A

Dominant

45
Q

A right handed person is what hemisphere dominant

A

Left

46
Q

Temporary blindness in 1 eye describes

A

Amaurosis fugax

47
Q

Amaurosis fugax comes for what artery

A

Ophthalmic artery
ipsilateral ICA

48
Q

Behavior changes come from what artery

A

Right MCA

49
Q

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

A

Homonymous hemianopia

50
Q

Stroke of the cerebral cortex is what

A

Homonymous hemianopia

51
Q

What vessel affects the entire side of the body, amaurosis fugax, and speech

a) ICA
b) MCA
c) ACA

A

a) ICA

52
Q

What vessel affects the face, arm, speech, and behavior

a) ICA
b) MCA
c) ACA

A

b) MCA

53
Q

What vessel affects the leg, incontinence, and loss of coordination

a) ICA
b) MCA
c) ACA

A

c) ACA

54
Q

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

A

MCA

55
Q

1) unilateral paresis
2) unilateral paresthesia/anesthesia
3) Dysphasia
4) Amaurosis fugax
5) Homonymous hemianopia

all of these symptoms come from which circulation

A

Anterior

56
Q

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

A

Posterior

57
Q

1) vertigo
2) ataxia
3) bilateral blurry vision
4) diplopia
5) bilateral paresthesia
6) drop attack

All of these symptoms come from which circulation

A

Posterior

58
Q

The sensation of moving/spinning around describes

A

Vertigo

59
Q

Lack of coordination describes

A

Ataxia

60
Q

What is dipolopia

A

Double vision

61
Q

Falling to the ground without losing consciousness describes

A

Drop attack

62
Q

____ ______= location unknown and tells us nothing

A

Non-localizing

63
Q

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

A

a) left ICA

  • Left eye = Left ICA
  • amaurosis fugax always goes with the same side ICA
64
Q

Which plaque has erosion of the fibrous cap

a) calcific
b) intraplaque hemorrhage
c) ulcerative
d) irregular

A

c) ulcerative

65
Q

What would cause a right hemispheric infarction

a) left ECA occlusion
b) right ECA occlusion
c) left ICA occlusion
d) right ICA occlusion

A

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.

66
Q

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

A

d) Left MCA

67
Q

What clinical finding is consistent with vertebrobasilar insufficiency

a) amaurosis fugax
b) syncope
c) dysphasia
d) diplopia

A

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

68
Q

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

A

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

69
Q

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

A

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

70
Q

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

A

d) Severe distal ICA stenosis

71
Q

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

A

a) Atheroemboli from the left ICA

72
Q

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

A

b) Fibromuscular dysplasia

73
Q

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

A

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