Clinical Stroke N25

Question 1

Transient Ischemic Attack (TIA)

Answer 1

stroke in evolution

Question 2

Cerevrovascular Accident (CVA)

Answer 2

completed stroke

Question 3

Modifiable Risk factors

Answer 3

SMOKING, high BP, high cholesterol, atherosclerosis, sedentary, obesity, alcohol use, diabetes mellitus , A fib

Question 4

3 types of ischemic stroke

Answer 4

thrombolytic, embolic, lacunar

Question 5

Thrombolytic ischemic stroke

Answer 5

plaque, turbulent flow, patients condition is abrupt onset, WORSENING, elevated BP

Question 6

Embolic ischemic stroke

Answer 6

occlusion of smaller vessels due to dislodged thrombus, maximal deficit at presentation (NOT WORSENING), normal BP, neurologic changes

Question 7

Lacunar ischemic stroke

Answer 7

occlusion of vessels leading to DEEP WHITE MATTER;
Contralateral PURE MOTOR deficit: Internal Capsule
Contralateral PURE SENSORY deficit: Thalamus
Ataxic Hemiparesis: Cerebellum
Clumsy Hand Dysarthria: PONS
Sensorimotor: mixed

Question 8

Hemorrhagic stroke types

Answer 8

Subarachnoid: between arachnoid and pia
Intracerebral: within brain

Question 9

Subarachnoid hemorrhagic stroke presentation

Answer 9

acute, terrible headache, nausea, vomiting, high BP, non-focal neurologic exam, nuchal rigidity, CSF is bloody

Question 10

Intracerebral hemorrhagic stroke presentation

Answer 10

acute, rapid progression, vomiting, BP elevates, FOCAL neurological changes (most common in putamen)

Question 11

Watershed Infarct

Answer 11

ischemia of marginal flow areas, may be due to treatment of high BP (reduce BP and CBF to marginal areas)

Question 12

Occlusion of Anterior Cerebral Artery

Answer 12

Contralateral hemiplasia/anesthesia LOWER LIMB, dysphagia, contralateral neglect,

Question 13

Occlusion of Middle Cerebral Artery

Answer 13

Contralateral hemiplasia/anesthesia UPPER LIMB/FACE, dysphagia, contralateral neglect

Question 14

Occlusion of Posterior Cerebral Artery within Brainstem

Answer 14

Vertigo, Ataxia, Visual changes, syncope, memory loss

Question 15

Occlusion of Posterior Cerebral Artery within Occipital Lobe

Answer 15

CN III palsy, impaired memory and visual changes

Question 16

Imaging Modalities

Answer 16

CT, MRI, etc

Question 17

CT contrast

Answer 17

bone: white, blood: white/gray, calcifications: white, Fluid: gray, brain matter: gray

Question 18

CT contrast for strokes

Answer 18

Thombotic: dark gray; hemorrhagic: white; if its within brain tissue (intracerebral), outside of brain within skull (subarachnoid)