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MISC > CVA > Flashcards

CVA Flashcards

1
Q

A 68 y/o hemiplegic patient presents with contralateral grasp reflex, sucking reflex, gegenhalten and gait apraxia. What structure is involved?
a. MCA
b. PCA
c. ACA
d. ICA

A

c. ACA

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2
Q

Non-fatigable clonus, less than 10 seconds when maintaining pressure, at a precise angle
a. 1
b. 4
c. 2
d. none of these
e. 3

A

d. none of these

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3
Q

In lateral medullary (Wallenberg) syndrome, all of the following can be seen except:
a. Decrease in pain and temperature sensation on the ipsilateral side of the face
b. Decreased pain and temperature on the contralateral body
c. Decrease muscle strength on the contralateral side
d. Ptosis, anhidrosis, and miosis on the ipsilateral side

A

c. Decrease muscle strength on the contralateral side

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4
Q

A patient presents with complete tetraplegia and locked in syndrome after sustaining CVA. The patient is unable to speak, but cognitively remains intact. The Most likely artery involved with the CVA is the:
a. Anterior cerebral artery
b. Middle cerebral artery
c. Posterior cerebral artery
d. Vertebral-basilar artery

A

d. Vertebral-basilar artery

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5
Q

Occlusion of the posterior inferior cerebellar artery (PICA) will damage all of the following structures, EXCEPT:
a. Corticospinal tracts
b. Nucleus and descending tracts of CN V
c. Nucleus ambiguous
d. Lateral spinothalamic tracts
e. Spinocerebellar tract

A

a. Corticospinal tracts

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6
Q

Kind of stroke that is characterized by seizure:
a. thrombotic
b. embolic
c. hemorrhagic
d. lacunar
e. NOTA

A

c. hemorrhagic

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7
Q

Modifiable Risk Factors for Stroke include the following, except:
a. HTN
b. Hypercholesterolemia
c. Race
d. Atrial Fibrillations
e. Smoking

A

c. Race

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8
Q

Memory impairment results from occlusion of what artery?
a. ACA
b. ICA
c. MCA
d. lenticulostriate
e. PCA

A

e. PCA

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9
Q

Occlusion of the main trunk of the left middle cerebral artery usually results in the following deficits
I. Hemianesthesia
II. Expressive aphasia
III. Receptive aphasia
IV. Hemiplegia
a. I, II and III
b. only IV
c. I and III
d. all of these
e. II and IV

A

d. all of these

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10
Q

You are performing a neurological evaluation on a patient that has vascular injury with the following impairments: loss of consciousness, coma, inability to speak and hemiplegia. Based on this information, which of the following areas does this vascular injury occur?
a. ACA
b. PCA
c. MCA
d. VBA

A

d. VBA

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11
Q

The artery involved in wallenburg syndrome:
a. Superior cerebellar artery
b. Anterior inferior cerebellar artery
c. Posterior inferior cerebellar artery
d. Vertebrobasilar artery
e. None of these

A

c. Posterior inferior cerebellar artery

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12
Q

Pure motor stroke is involvement of:
a. Anterior limb of the internal capsule
b. Posterior limb of the internal capsule
c. Thalamus
d. Subthalamic nucleus

A

b. Posterior limb of the internal capsule

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13
Q

In weber syndrome, where is the lesion?
a. Tegmentum of the brainstem
b. Basal midbrain
c. Lateral pons
d. Basal pons

A

b. Basal midbrain

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14
Q

All of the following are true about broca’s aphasia, except:
a. Patient’s has poor writing ability
b. Good reading comprehension
c. Patient can easily comprehend verbal commands
d. Lesion is in third frontal convolution
e. None of these

A

e. None of these

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15
Q

More marked increase in muscle tone through most of the range of motion but joint is easily moved.
a. 1
b. 1+
c. 2
d. 3
e. 4

A

c. 2

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16
Q

It is characterized by sudden severe headache, often described as “the worst headache of my life,” with or without focal neurologic deficit, and often with altered mental status
a. Subararachnoid hemorrhage
b. Atherothrombotic stroke
c. Cardioembolic stroke
d. Lacunar Stroke
e. Intracerebral Aneurysm

A

a. Subararachnoid hemorrhage

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17
Q

The following are manifestations of the Lateral Medullary Syndrome or Wallenberg syndrome, EXCEPT:
a. Ipsilateral Horner syndrome
b. loss of ipsilateral pain and temperature on the body
c. ipsilateral impaired sensation of face
d. Ipsilateral limb ataxia

A

b. loss of ipsilateral pain and temperature on the body

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18
Q

A patient has normal fluency and comprehension but upon repetition, expression is impaired. He has which of the following aphasia?
a. Broca
b. Wernicke
c. Global
d. Anomia
e. Conduction

A

e. Conduction

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19
Q

All are classic lacunar syndrome, except:
a. Pure motor hemiparesis
b. Pure hemisensory
c. Sensori-motor stroke
d. Clumsy hand-dysarthria
e. NOTA

A

e. NOTA

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20
Q

Brunstromm stage of motor recovery where in there is prominence of spasticity and the patient voluntarily moves the limb, but ms activation is all within the synergy patterns:
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
e. Stage V

A

c. Stage III

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21
Q

Your 25 y/o patient presents with seizure, migraine & hemorrhage. Hemorrhage was found to be between cerebral arteries and veins. Knowing this presentation you opt to check the patient’s chart for his diagnosis. It is noted in the chart that this patient has:
a. Saccular Berry Aneurysm
b. Arteriovenous Malformation
c. Subarachnoid Hemorrhage
d. Embolic Stroke

A

b. Arteriovenous Malformation

22
Q

Most common site of hypertensive hemorrhagic stroke
a. putamen
b. thalamus
c. caudate
d. lentiform nucleus
e. globuspallidus

A

a. putamen

23
Q

Occurs in the presence of thromobolitic disease and is the result of temporary ischemia in the brain and surrounding tissues. Symptoms do not last long and do not show changes on CT scan or MRI:
a. Reversible Ischemic Neurologic Deficit
b. Complete Stroke
c. Stroke in Evolution
d. Transient Ischemic Attack
e. NOTA

A

d. Transient Ischemic Attack

24
Q

A patient cannot find his dentures when they are on his crowded bedside table. His visual acuity tests at 20/20with the Snellen eye chart. The PT suspects problems with:
a. Figure-ground discrimination
b. Body scheme awareness
c. Agraphia
d. Vertical orientation

A

a. Figure-ground discrimination

25
Q

The Most common site of occlusion in stroke:
a. MCA
b. ACA
c. PCA
d. Anterior communicating artery

A

a. MCA

26
Q

Todd is a 46-year-old man who has an inability to recognize familiar objects. What do you suspect he has?
a. Apraxia
b. Angina
c. Aphasia
d. Agnosia

A

d. Agnosia

27
Q

All of the following are true about locked in syndrome except:
a. CST are affected on both sides
b. Long tracts of cranial nerve are also affected bilaterally
c. Pt may be in COMA
d. Cognition is spared
e. NOTA

A

e. NOTA

28
Q

Which of the following problems is not generally seen after a person has a CVA?
a. Auditory deficits
b. Tactile deficits
c. Perceptual deficits
d. Motor impairments

A

a. Auditory deficits

29
Q

The primary site of origin for cerebral emboli is the:
a. Superficial leg veins
b. Deep leg veins
c. Heart
d. Lungs
e. Lymphatic system

A

c. Heart

30
Q

Cerebral embolism accounts for what percentage of all pathologically documented strokes?
a. Less than 1%
b. 10%
c. 25%
d. 50%
e. 75%

A

c. 25%

31
Q

Rupture of a “berry” aneurysm primarily leads to:
a. Cerebral embolism
b. Subarachnoid hemorrhage
c. Cerebral thrombosis
d. Intracerebral hemorrhage
e. There are usually no clinical findings

A

b. Subarachnoid hemorrhage

32
Q

Recovery in a middle cerebral artery stroke is usually most complete in the muscles around the:
a. Hand
b. Shoulder
c. Hip
d. Ankle
e. All of the above recover equally

A

c. Hip

33
Q

Dysarthria clumsy hand syndrome involved what part?
a. Posterior limb of the internal capsule
b. Anterior limb of the internal capsule
c. Pons
d. Medulla

A

b. Anterior limb of the internal capsule

34
Q

Type of stroke in the young:
a. Hemorrhagic
b. Lacunar
c. Embolic
d. Thrombotic

A

a. Hemorrhagic

35
Q

A third cranial nerve involvement is usually secondary to a stroke involving the:
a. All of these
b. Posterior cerebral artery
c. Anterior cerebral artery
d. Middle cerebral artery

A

b. Posterior cerebral artery

36
Q

A PT examines a patient rehabilitating from an MCA stroke. Which condition is NOT typically associated with this type of stroke?
a. Urinary incontinence
b. Contralateral hemiplegia
c. Aphasia
d. Homonymous hemianopsia

A

a. Urinary incontinence

37
Q

In locked in syndrome, the patient is:
a. Paralyzed with possible preserved vertical gaze and blinking
b. Unable to speak
c. Aware
d. All of these

A

d. All of these

38
Q

A female patient who is status post stroke is working on ambulation in physical therapy. The patient has good sensation and her strength is within functional limits. When walking in the community, the patient is able to walk up stairs with supervision. Yet, when the patient practices this task in the therapy gym, the patient is unable to complete the activity. This problem is MOST likely a problem of:
a. Ideomotor apraxia
b. Impaired body schema
c. Impaired problem solving
d. Ideational apraxia

A

a. Ideomotor apraxia

39
Q

A PT reviews the medical record of a patient rehabilitating from a CVA that involves the left hemisphere. Diagnostic imaging revealed that the stroke involved the middle cerebral artery. The MOST likely clinical finding based on the patient’s diagnosis is:
a. Aphasia
b. Visual agnosia
c. Perseveration
d. Dysmetria

A

a. Aphasia

40
Q

Computer tomography reveals that a patient admitted to the hospital two days ago sustained a stroke involving the left middle cerebral artery. Based on the identified area of involvement the patient would MOST likely demonstrate the following signs and symptoms, EXCEPT:
a. Apraxia
b. Aphasia
c. Right hemiparesis
d. Neglect

A

d. Neglect

41
Q

You are evaluating the motor control of a 65-year-old client who sustained a brainstem CVA 3 months ago. When performing the finger to nose test, the client reach seems to have:
a. Ataxia
b. Chorea
c. Ballism
d. Athetoid movement

A

a. Ataxia

42
Q

Hemianopsia is a loss of visual field secondary to a stroke. The most probable visual loss for a right cerebrovascular accident (CVA) would be:
a. Temporal side of the right eye and the nasal side of the left eye
b. Nasal side of the left eye and the nasal side of the right eye
c. Nasal side of the right eye and temporal side of the left eye
d. Nasal and temporal sides of the left eye only

A

c. Nasal side of the right eye and temporal side of the left eye

43
Q

When designing an intervention plan for a patient diagnosed with a CVA, all of the following are primary impairments associated with stroke, EXCEPT:
a. Visual changes, including neglect and visual field deficits
b. Changes in emotional status
c. Pain
d. All are primary impairments associated with stroke

A

d. All are primary impairments associated with stroke

44
Q

Your supervisor is watching you examine a patient in the intensive care unit who recently suffered a stroke. Your evaluation reveals contralateral hemiplegia (upper extremity involvement greater than lower extremities), homonymous hemianopsia, aphasia, and contralateral loss of sensation in the upper extremities. Your supervisor asks you which of the cerebral arteries is the likely location of the lesion?
a. Middle cerebral artery
b. Anterior cerebral artery
c. Posterior cerebral artery
d. Lateral cerebral artery

A

a. Middle cerebral artery

45
Q

Which of the following is the most important to assess first during an evaluation of a patient with a recent stroke?
a. Sensory status
b. Motor control
c. Mental status
d. Ambulation potential

A

c. Mental status

46
Q

The most common type of stroke is ____________, and its primary precipitating factor is _____________.
a. Atherothrombotic, atherosclerosis
b. Atherothrombotic, hypertension
c. Hemorrhage, atherosclerosis
d. Hemorrhage, hypertension

A

a. Atherothrombotic, atherosclerosis

47
Q

A physical therapist is ordered to evaluate a 65-year-old woman who has suffered a recent stroke. The occupational therapist informs the physical therapist that the patient has apraxia. She cannot brush her teeth on command. However, she can point out the toothbrush and verbalize the purpose of the brush. From this information, what sort of apraxia does this patient have? How should the physical therapist approach treatment?
a. Ideomotor apraxia. The physical therapist should speak in short, concise sentences.
b. Ideomotor apraxia. The physical therapist should always give the patient 3-step commands.
c. Ideomotor apraxia. The physical therapist should always give the patient 5-step commands.
d. Ideational apraxia. The physical therapist should speak in short, concise sentences.

A

a. Ideomotor apraxia. The physical therapist should speak in short, concise sentences.

48
Q

The patient is now able to pronate and supinate his affected forearm with the elbow extended. The patient can also perform palmar prehension and cylindrical grasp. This means he is in the stage of Brunnstrom’s stages of development:
a. 3
b. 2
c. 4
d. 5

A

d. 5

49
Q

Following a cerebrovascular accident on the dominant right hemisphere, a patient exhibiting unilateral neglect might do the following with the exception of:

a. Eating food only from the right side of the plate.

b. Bumping a one-arm drive wheelchair into things on the left side.

c. Ignoring or denying existence of the left-sided limbs.
d. Shaving or putting makeup only on the left side of the face.

A

d. Shaving or putting makeup only on the left side of the face.

50
Q

Intracranial aneurysm are usually saccular occurring at vessel bifurcations. 40%of the saccular aneurysms occurs at:
a. Middle cerebral artery trifurcation and bifurcation
b. Basilar artery
c. Posterior inferior cerebellar artery
d. Anterior communicating artery
e. Ophthalmic artery

A

d. Anterior communicating artery

MISC (6 decks)

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