Cerebrovascular Disease: Continuum Deck 1 (Clinical Eval. and Tx of Ac Is Stroke

Question 1

First two critical questions

Answer 1

LKW (time not hours)

+/- AC (take last dose ?)

Question 2

Things to observe initially on the way to the CT

Answer 2

Alert, commands, eyes, head/gaze deviation, limb position and presence of purposeful movements

Question 3

Stroke alert first 5 steps

Answer 3

LKW/AC ? , Vitals CAB and <185/110, glucose, Observe then NIH

Question 4

You only need a glucose but order these 5 additional labs.

Answer 4

PT/PTT/INR, Plt, CBC, CMP, troponins

Question 5

Three things you need from the nurse first

Answer 5

BP, Glucose, and 2 IVs

Question 6

Key to stroke syndromes

Answer 6

does the presentation make neuroanatomic sense ?

Question 7

What is stroke ?

Answer 7

Acute focal infarction of the cerebral, spinal or retinal tissue.

Question 8

ICA syndrome S/Sx

Answer 8

ACA/MCA syndrome, amoaurosis fugax/altitudinal field cuts

Question 9

L ACA

Answer 9

Right leg weak/numb, transcortical motor aphasia, ideomotor apraxia (i/l or c/l)

Question 10

R ACA

Answer 10

Left leg weak/numb, motor neglect, ideomotor apraxia (i/l or c/l)

Question 11

L MCA

Answer 11

Right face/arm >leg numb/weak, aphasia and left gaze preference

Question 12

R MCA

Answer 12

Left Face/arm >leg numb/weak, left hemineglect, right gaze preference, agraph/astereo

Question 13

L PCA

Answer 13

Right hemianopsia, alexia w/o agraphia, MIDBRAIN (WEBER) CN 3 I/L with mydriasis and hemiparesis

Question 14

R PCA

Answer 14

left hemianopsia and/or Weber syndrome CN 3, mydriasis and hemiparesis

Question 15

SCA

Answer 15

I/L limb and gait ataxia

Question 16

AICA

Answer 16

Vertigo, I/L deafness, and/or i/l facial weakness/ataxia

Question 17

Vert/PICA

Answer 17

I/L limb and gait ataxia and/or Wallenberg syndrome (lateral medulla)

Question 18

Basilar

Answer 18

Pontine with impaired lateral gaze, horizontal diplopia and dysconjugate gaze, dysarthria, locked in