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Medical Pathology > Lecture 5: Stroke 2 > Flashcards

Lecture 5: Stroke 2 Flashcards

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USMLE® Step 1 flashcards
1
Q

which gyrus is motor

A

precentral gyrus

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2
Q

which gyrus is sensory

A

post central gyrus

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3
Q

which three ways can the brain show injury

A

decreased loss of consciousness, seizures, and localizing signs ( hemiparesis, hemiplegia, dysphasia, visual disturbances, etc)

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4
Q

common symptoms of acute stroke are usually

A

sudden

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5
Q

what are the most common areas that are affected by stroke

A

face, arm, or leg; brain; eyes; stomach; body; legs

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6
Q

deficits to this part of the brain include: paralysis, inability to sequence a task/plan, eye movements, personality changes, difficulty with prob solving, changes in social behavior, and inability to express language ( Brocas Area)

A

frontal lobe deficits

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7
Q

deficits to this lobe include : inability to name an object, difficulty reading, difficulty with hand eye coordination, difficulty drawing objects, sensory defects, and akinetopsia

A

parietal lobe deficits

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8
Q

what is it called when the image is not continuous but choppy and you get glimpses of images

A

akinetopsia

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9
Q

deficits to this pt of the brain include: trouble recognizing faces, short and longterm memory defects, hearing probs, increased aggressive behavior, visual field defects, trouble understanding spoken words, increased or decreased interest in sexual behavior

A

temporal lobe defects

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10
Q

deficits to this lobe involve visual changes: hemianopia, Quadrantanopsia, visual field defects, color recognition, trouble reading and writing, trouble recognizing drawn objects, diplopia, vertigo, dizziness

A

occipital lobe defects

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11
Q

what are the two types of hemispherical strokes that affect visual field

A

homonymous hemianopsia and hemispatial neglect

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12
Q

what is loss of half the field of vision in each eye

A

homonymous hemianopsia

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13
Q

what is technically not a vision problem, and is the inability to attend to one side of the world

A

hemispatial neglect

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14
Q

what are the side effects of left hemisphere stroke

A

aphasia ( dysarthria - speakinh ), right hemiparesis, right sided sensory loss, right visual field defect, poor right conjugate gaze, trouble reading, writing, or calculatin

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15
Q

what are the side effects of right hemisphere stroke

A

left neglect, defect of L visual field, left hemiparesis, left sided sensory loss, poor L conjugate gaze, dysarthria, spatial disorientation

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16
Q

what is disorder of speech called

A

dysarthria -> imperfect articulation of speech sounds, changes in voice pitch or quality

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17
Q

what is the inability to comprehend, integrate, and express language

A

aphasia-> affects 34-38% of stroke pts , of that 1/2 have resolve on their own

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18
Q

what are the two types of aphasia

A

receptive ( fluent ) and expressive ( non fluent)

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19
Q

what type of aphasia is when someone can internally think what they want to say but it comes out as jibberish

A

receptive aphasia

20
Q

what type of aphasia is when a person can understand what you are saying but cant answer them properly

A

expressive aphasia

21
Q

what are common signs of cerebellar stroke

A

vertigo, HA , vomiting, ataxia ( coordination probs, inability to walk, inability to reach out and grab objects

22
Q

what is the most common stroke area of the cerebellum

A

posterior inferior cerebellar artery

23
Q

brain stem strokes involves…

A

cranial nuclei and long tracts

24
Q

what usually occurs with cranial nuclei in brain stem strokes

A

diplopia

25
Q

what happens with pure motor ( long tracts) in brain stem strokes

A

weakness of the face and limbs on one side of the body; no higher brain function, sensation, or vision deficits

26
Q

what happens with pure sensory in brain stem strokes

A

decreased sensation of face and limbs on one side of body; no higher brain function , motor, or vision deficits

27
Q

what is the most common vessel involved with stroke

A

middle cerebral artery

28
Q

what signs do you check for stroke

A

Face, Arm, Speech, Time ( FAST)

29
Q

what is the Cincinnati prehospital stroke scale

A

have pt smile ( facial droop); have pt close eyes and hold arms out ( arm drift ); have pt say “: you cant teach an old dog new tricks ( speech)

30
Q

what test can confirm the dx of stroke and tell whether the stroke is caused by hemorrhage in the brain

A

CT scan

31
Q

what test can identify and further localize the site of the stroke and find the source

A

MRI/MRA

32
Q

what can pinpoint the exact location of blockage or bleeding in the brain ; historical gold standard; replaced by CTA/ MRA

A

Angiography

33
Q

what are the two types of hematomas

A

subdural and epidural

34
Q

which hematoma is usually due to trauma

A

subdural

35
Q

which hematoma has a crescent shape in CT scan

A

subdural

36
Q

which hematoma has a lenticular shape in CT scan

A

epidural

37
Q

in what type of stroke does the denseness of blood change over time ( gets darker as it goes from acute- subacute- chronic)

A

hemorrhagic

38
Q

In a CT scan which color represents low blood flow areas

A

purple

39
Q

which test allows for good soft tissue differentation and we use it to look at the arteries, the downside is its expensive and takes a long time

A

MRI

40
Q

which test allows for good view of the vessels

A

MRA

41
Q

what is an effective ischemic stroke tx

A

tissue plasminogen activator

42
Q

what does tissue plasminogen activator do

A

IV; dissolves the clot; restores some blood flow; can cause hemorrhaging; must be admin. within 3 hours of symptom onset ( only 1-7 % receive this therapy bc its hard to get people in hospital in 3 hours )

43
Q

what are some hemorrhagic stroke tx

A

surgery, control of bp, discontinue anticoagulant therapy

44
Q

what is the number one thing we can do to prevent stroke

A

HTN

45
Q

what is the survival rate of stroke

A

50%

46
Q

what is the rule of thirds of stroke

A

1/3 recover with no or minimal disability; 1/3 recover with residual disability; and a 1/3 die

47
Q

what is the human cost of stroke among survivors

A

some require daily assistance, some need help walking, some live permanently in nursing homes, and some are work impaired

Medical Pathology (11 decks)

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