CVA TIA, Pales II

Question 1

aphasia

Answer 1

inability to speak (motor or sensory)

Question 2

alexia

Answer 2

inability to read

Question 3

agraphia

Answer 3

inability to write

Question 4

dysphagia

Answer 4

difficulty swallowing

Question 5

dysarthria

Answer 5

slurred speech

Question 6

hemispatial neglect

Answer 6

inability to attend one side of body or visual field

Question 7

apraxia

Answer 7

inability to perform a specific task

Question 8

anosognosia

Answer 8

unawareness of or denial of the existence of disability

Question 9

anomia

Answer 9

difficulty recalling words or names

Question 10

ataxia

Answer 10

unsteady gait

Question 11

what supplies basal ganglia

Answer 11

lenticulostriate

Question 12

lenticulostriate come off what a

Answer 12

MCA

Question 13

Characteristics of MCA syndrome

Answer 13

contralateral hemiplegia/ sensation loss

contralateral homonymous hemianopsia

Question 14

dominant side MCA syndrome

Answer 14

aphasia, alexia, agraphia, acalculia, finger agnosia, R-L confusion

Question 15

non-dominant side MCA syndrome

Answer 15

unilateral neglect
dressing apraxia
anosognosia
constructional apraxia

Question 16

Anterior artery syndrome

Answer 16

contralateral sensory and motor loss of lower extremity

Question 17

PCA syndrome

Answer 17

homonymous hemianopsia
alexia without agraphia
visual or color anomia

Question 18

Lateral pontine syndrome

Marie-Fox syndrome

Answer 18

AICA
ataxia- arm and leg
weakness- upper and lower extremity
hemisensory loss- pain and temperature

Question 19

Lateral Medullary Syndrome

Wallenberg syndrome

Answer 19

PICA
facial sensory loss and pain
ataxia
nystagmus
vertigo
hoarseness
dysphagia
horner syndrome
hemisensory loss
hiccups

Question 20

what strokes occur off basilar artery

Answer 20

locked in syndrome
lateral pontine
ventral pontine
ataxic hemiparesis
cortical blindness

Question 21

lateral gaze weakness and contralateral hemiplegia

Answer 21

ventral pontine syndrome

Raymond Syndrome

Question 22

contralateral UE and LE weakness

ipsi facial weakness

Answer 22

ventral pontine syndrome

Millard Gubler Syndrome

Question 23

quadriplegia, b/l facial paralysis, dysarthria

Answer 23

locked in syndrome

Question 24

other sx of stroke

Answer 24

HA
nausea/vomiting
stupor/coma/amnesia/confusion/delerium

Question 25

Amaurosis Fugax

Answer 25

transient mono ocular blindness | warning sign impending stroke

Question 26

causes of amaurosis fugax

Answer 26

``` embolic hemodynamic ocular neurologic idiopathic ```

Question 27

Sx of TIA

Answer 27

last less than 24 hours

Question 28

increased risk for what if have TIA

Answer 28

CVA within first 3 mo

Question 29

Dx of stroke

Answer 29

Hx: sudden onset do complete neuro and mental status exam CT w/o contrast (only detects big strokes)

Question 30

more sensitive imaging for stroke

Answer 30

MRI not CT

Question 31

looking for cause of stroke lab workup

Answer 31

``` Hx lipids, blood glucose, cardiac enzymes EKG, arrhythmia MI echo carotid doppler MR-A/ CT-A ```

Question 32

differential for ischemic stroke

Answer 32

``` hemorrhagic or subdural hematoma seizures complex migraines CNS tumors nerves palsy encephalitis toxic metabolic encephalopathy syncope vertigo ```

Question 33

common cause for confusion of hospitalized patients

Answer 33

toxic metabolic encephalopathy

Question 34

Tx types for stroke

Answer 34

acute primary stroke prevention secondary stroke prevention

Question 35

acute Tx for stroke

Answer 35

``` rtPA (within 3 hrs) Aspirin IV fluids keep BP sufficient, not too high swallowing evaluation early rehab ```

Question 36

non modifiable risk factors for stroke

Answer 36

age (>55) +FMH race: african american and hispanics>caucasians gender: M>F personal Hx TIA CVA MI any atherosclerosis

Question 37

modifiable risk factors for stroke

Answer 37

``` HTN!! second biggest Afib smoking DM!!! biggest carotid stenosis HLD physical inactivity and obesity alcohol and drug abuse geographic location socioeconomic factors ```

Question 38

stroke prevention efforst

Answer 38

diet (low sat fat) exercise (aerobic 30 min 3-5 days) strict control BP, sugars and cholesterol quit smoking

Question 39

medications for stroke prevention

Answer 39

antiplatelets | anticoagulatns

Question 40

what are the antiplatelet drugs

Answer 40

aspirin clopidogril aspiring/dipyridamole

Question 41

what are the anticoagulation drugs

Answer 41

warfarin | heparin and LMWH

Question 42

tx options of carotid stenosis

Answer 42

depends on degree of stenosis medical Tx surgical Tx with endarterectomy stents

Question 43

indications for stent in carotid stenosis

Answer 43

lesions not reachable with surgical approach | patients have high surgical risk

Question 44

alexia without agraphia

Answer 44

PCA syndrome

Question 45

multiple strokes all over brain

Answer 45

emboli from heart

Question 46

major risk factors for strokes

Answer 46

atherosclerosis and HTN

Question 47

CT can miss what

Answer 47

early strokes because small or in posterior circulation

Question 48

major Tx of ischemic stroke

Answer 48

tPA