Cerebrovascular Disorders Flashcards
Question 1 of 9
Mabel, age 62, is brought to the emergency department by her son, Tom. Tom informs the nurse practitioner that 2 years ago he brought his mother to the emergency department because during dinner the right side of her face seemed to be drooping and she was slurring her words. By the time they had reached the emergency department on that occasion, the symptoms seemed to have disappeared and Mabel stated she had felt fine, but tired.
Tonight, Mabel is struggling to walk normally, with weakness apparent on her right side. She also has difficulty speaking and struggles to form simple responses to standard medical history questions.
When Mabel presented at the emergency department 2 years ago, with initial symptoms such as facial drooping and slurred speech that seemed to disappear, what may have been a possible diagnosis? ECHO Transient ischemic attack (TIA) Subarachnoid hemorrhage (SAH) Lacunar infarct
Transient ischemic attack (TIA)
TIA stands for transient ischemic attack, which is a transient disruption in cerebral blood flow. Initial signs and symptoms may go unnoticed by the patient and will resolve within 24 hours.
Question 2 of 9
TIAs used to be considered mild events but are now categorized as medical emergencies. What percentage of patients who present with TIA will have a stroke in the future? 5% to 10% 10% to 15% 20% to 25% More than 50%
20% to 25%
An estimated 20% to 25% of TIAs progress to stroke. Risk factors for TIAs are the same as those for stroke, including atrial fibrillation, hypertension, diabetes mellitus, and carotid stenosis. As so many TIAs progress to stroke, evaluation by a clinician is recommended.
Question 3 of 9
Tom stated he brought his mother directly to the emergency department since they were only two blocks away at the time. He stated he remembered an acronym that describes when someone may be suffering from a stroke and decided to seek help. Which acronym did Tom remember? SAH RIGHT FAST STROKE
FAST
The FAST acronym was created to alert people to the signs of a stroke: Facial droop, Arm weakness, Speech difficulty, and Time to call 911.
Question 4 of 9
Mabel suffers from a history of atrial fibrillation, high blood pressure, and diabetes. She is taking antihypertensive medications. She used to smoke but she quit 4 years ago. Cardiovascular disease runs in her family. Her father died of a heart attack at age 52. Which of the following factors increase Mabel’s risk for cerebrovascular disorders? Select all that apply. Atrial fibrillation High blood pressure Diabetes Family history of cardiovascular disease Female sex
Atrial fibrillation
High blood pressure
Diabetes
Family history of cardiovascular disease
Men have a higher risk for stroke. Atrial fibrillation, high blood pressure, diabetes, and family history of cardiovascular disease all increase the risk for stroke.
Question 5 of 9
Tom wants to know why his mother’s heart condition, atrial fibrillation, may increase her risk for stroke. Which of the following response is correct?
Tom is misinformed. Atrial fibrillation does not increase the risk for stroke.
Atrial fibrillation reduces blood clotting, which increases the risk of stroke.
Atrial fibrillation causes regurgitation of blood into carotid arteries, increasing stroke risk.
Atrial fibrillation increases the risk of clot formation, which can lead to stroke.
Atrial fibrillation increases the risk of clot formation, which can lead to stroke.
Atrial fibrillation causes quivering of the atria, resulting in stasis of blood flow. Blood flow stasis increases the risk for clot formation and subsequent stroke.
Question 6 of 9
Which area of Mabel’s brain appears to be affected? Frontal lobe Right hemisphere Cerebellum Left hemisphere
Left hemisphere
Mabel likely has damage to the left hemisphere, as her signs and symptoms are present on the right side of her body.
Question 7 of 9
A CT scan without contrast is ordered. What information may be provided by this test?
Helps determine if Mabel is suffering a myocardial infarction
Helps determine is the stroke is hemorrhagic or ischemic
Helps determine the blood pressure within cerebral arteries
Helps determine if atrial fibrillation is present
Helps determine is the stroke is hemorrhagic or ischemic
To correctly treat a stroke, the type of stroke must be determined. A CT scan can help differentiate between an ischemic and hemorrhagic stroke.
Question 8 of 9
The CT scan results show no cerebral bleeding. What type of stroke is Mabel experiencing? Hemorrhagic Subarachnoid hemorrhage Ischemic Lacunar
Ischemic
Without cerebral bleeding detected, Mabel is likely suffering from an ischemic stroke. A stroke caused by bleeding is known as a hemorrhagic stroke. In Mabel’s case her stroke developed not from bleeding but rather an obstruction of blood flow, disrupting oxygen delivery.
Question 9 of 9
Of the following, which treatment option may be considered for Mabel? IV mannitol solution Coagulation stimulators Platelet activators rt-PA
rt-PA
rt-PA is recombinant tissue plasminogen activator, otherwise known as a “clot buster.” Specific guidelines exist for usage of this agent, but it can be a treatment used for ischemic stroke.
Question 1 of 5
What are the three primary categories of cerebrovascular disease? Select all that apply.
Transient ischemic attack Coup-contrecoup stroke Diffuse axonal stroke Hemorrhagic stroke Ischemic stroke
Transient ischemic attack
Hemorrhagic stroke
Ischemic stroke
Question 2 of 5
What is the term for the cells surrounding an area of ischemia that are not irreversibly damaged?
Infarction zone
Ischemic penumbra
Ischemic zone
Infarction penumbra
Ischemic penumbra
Question 3 of 5
Which cerebrovascular disorder is a stroke-like syndrome that lasts minutes to hours and then resolves?
Hemorrhagic stroke
Lacunar infarction
Transient ischemic attack
Ischemic stroke
Transient ischemic attack
Question 4 of 5
Treatment of ischemic stroke may involve ________________.
clotting factor transfusion
hemodynamic stabilizers
thrombolytic agents
platelet-activating agents
thrombolytic agents
Question 5 of 5
Hemorrhagic strokes __________________.
are treated with “clot busters”
are not as severe as ischemic strokes
seldom result in significant damage
require hemodynamic stabilization
require hemodynamic stabilization
