CV 3 cerebrovascular disease

Question 1

neurological deficit secondary to abnormal perfusion of brain tissue

Answer 1

stroke

Question 2

permanent cerebrovascular disease

Answer 2

stroke

Question 3

syncope has many causes and most cases resolve in –

Answer 3

one hour

Question 4

stroke is the – cause of death

Answer 4

2nd

Question 5

rate of stroke and TIA doubles after the age of –

Answer 5

55

Question 6

ethnicity risk

Answer 6

twice for African Americans and Hispanics compared to whites

Question 7

HTN increases risk

Answer 7

4x

Question 8

diabetes and smoking increases risk

Answer 8

2x

Question 9

can oral contraceptives increase risk?

Answer 9

yes

Question 10

most strokes are

Answer 10

ischemic

Question 11

transient loss of consciousness caused by a global decrease in cerebral perfusion

Answer 11

TIA

Question 12

Cardiac syncope has the same causes as –

Answer 12

ischemic stroke (reduced CO)

Question 13

– syncope may be preceded by autonomic symptoms like nausea, sweating, light-headedness

Answer 13

vasovagal

Question 14

dehydration reduces intravascular volume leading to –

Answer 14

orthostatic syncope

Question 15

reproducible vasovagal syncope caused by forceful urination, defecation, coughing

Answer 15

situational syncope

Question 16

large artery stenosis

Answer 16

internal carotid, vertebral, basilar, branches of circle of Willis

Question 17

in addition to larger artery stenosis, cardiac emboli, and small vessel disease what are other causes of ischemic stroke?

Answer 17

sickle cell disease
hypercoagulable states
drugs
birth control pills
(compromise blood flow)

Question 18

small vessel disease is characterized by –

Answer 18

endothelial damage (small lacunar infarcts in deep brain)

Question 19

subarachnoid hemorrhage involves bleeding into the subarachnoid spaces and –

Answer 19

cerebrospinal fluid

Question 20

intracerebral hemorrhage involves rupture of arteries and bleeding in the –

Answer 20

brain parenchyma

Question 21

diffuse hemorrhage

Answer 21

subarachnoid

Question 22

focal hemorrhage

Answer 22

intracerebral

Question 23

caused by aneurysms, vascular malformation, trauma, DIC

Answer 23

subarachnoid hemorrhage

Question 24

caused by hypertensive hemorrhage, use of anticoagulants esp in older patients

Answer 24

intracerebral hemorrhage

Question 25

brain is supplied with --

Answer 25

14% of CO

Question 26

brain utilizes --

Answer 26

10% of blood glucose

Question 27

most commonly affected artery for focal ischemia?

Answer 27

middle cerebral artery

Question 28

may initially see occipital headache, unsteady gait, ataxia, nausea and vomiting

Answer 28

hemorrhagic stroke

Question 29

differentiates between ischemic and hemorrhagic strokes

Answer 29

CT scan

Question 30

first line diagnostic test for ischemia

Answer 30

CT scan

Question 31

sensitive for detecting early ischemia

Answer 31

MRI

Question 32

MRI is used to see relationship with --

Answer 32

surrounding tissues

Question 33

perfusion scanning that shows under-perfused areas

Answer 33

MRI

Question 34

gold standard for diagnosing ischemia

Answer 34

cerebral angiography

Question 35

cerebral angiography evaluates --

Answer 35

large intracranial and extracranial blood vessels

Question 36

shows changing blood flow with neural activity

Answer 36

fMRI

Question 37

real time test to see which parts of brain are active

Answer 37

fMRI

Question 38

purpose of non-contrast CT

Answer 38

differentiate ischemic and hemorrhagic stroke

Question 39

although t-PA is the main treatment of ischemic stroke, newer therapies include

Answer 39

angioplasty and stenting (catheter-based therapies)

Question 40

evidence suggest that -- is superior to medical treatment in cases of greater than 70% stenosis associated with symptoms such as TIAs

Answer 40

surgical carotid endarterectomy

Question 41

carotid endarterectomy removes -- from carotid artery to restores blood flow to brain

Answer 41

atherosclerotic plaque