Neuro 1 pt6

Question 1

Diff btwn stroke and syncope – they fall down and

Answer 1

blood makes it to the brain with syncope.

Question 2

Who most often gets Syncope?

Answer 2

Young people and old people

Question 3

D/O of movement and posture resultant from insult to immature CNS (in utero)
Developmental delay: failure of child to reach normal milestones of gross or fine motor, language, social-adaptive skills

Answer 3

Cerebral Palsy

Question 4

ratio of Cerebral Palsy cases with seizures, mental retardation

Answer 4

1/3 have seizures

60% mentally retarded

Question 5

What does TIA stand for?

Answer 5

Transient ischemic attack/stroke

Question 6

80-85% of strokes are ___, the rest are ___

Answer 6

most are ischemic

rest are hemorrhagic

Question 7

After a stroke, there is a 10.5% risk of another stroke in following __, but the highest risk in first __!

Answer 7

3 months

2 days

Question 8

ischemia from TIA is reversible for how long?

Answer 8

<24 hours

Question 9

2 causes of a stroke

Answer 9

blockage or hemorrhage

Question 10

__% cardiac output used by brain

Brain has only _ mins of glucose energy stores; - seconds of O2 stores

Answer 10

20%
2 minutes glucose energy
8-10 seconds of O2 in storage

Question 11

Stroke- pathogenesis can come from: (3)

Answer 11

ABC’s

Artery, blood, cardiac reasons

Question 12

Stroke pathogenesis from ABC

Artery (4)

Answer 12

hemodynamic signif stenosis(low flow), atherosclerosis in neck
Carotid dissection (tear of intima of vessel)
Intracranial stenosis

Question 13

Stroke pathogenesis from ABC

Blood (2)

Answer 13

acquired and genetic prothrombotic states.
Any inflammatory state (like UTI/PNA) will produce cytokines and interleukins which will make the platelets more “sticky”

Question 14

Blood reasons for a stroke: What is an lg. protein that participates directly to plt adhesion at site of vessel injury

Answer 14

Von Willebrand factor

Question 15

5 cardiac reasons for a stroke (hint: 3 are the same thing)

Answer 15

a.fib
a.fib
a.fib
PFO (patent foramen ovale)
low EF%

Question 16

Tests to run following a stroke: (7)

Answer 16

STAT head CT(N/V favor bleed)
CTA arch/neck/head (Computed Tomography Angiography)
angiography and possible clot retrieval
MRI Brain(-)/MRA neck(+)/head(-)
TTE/TEE (trans thoracic/esophogeal echocardiogram)
Carotid Doppler - vestige of workup of old

Question 17

(stroke) What test is this? – inject iodine dye. See how brain takes it up, see if the brain is dying.

A / mismatch means there is some brain to save

Answer 17

CT Perfusion

Diffusion/Perfusion mismatch means there is some brain to save

Question 18

Run which test when there is a PFO causing a stroke?

Answer 18

LE Dopplar

Question 19

If there is a real allergy to IV dye in CT scan using IV dye, do what? (2)

Answer 19

Prednisone 60mg 13h, 7h & 1 hour prior to test

Benadryl 50mg 1 hour prior to test

Question 20

Anterior circulation stroke vs. posterior circulation stroke depends on where it occurs in relation to:

Answer 20

Circle of Willis

Question 21

How many branches does internal carotid have in the neck?

Answer 21

Zero. (Ext. carotid has branches in the neck)

Question 22

*ACA (Anterior cerebral artery) infarct affects the __

Answer 22

*right leg paresis/plegia

Question 23

Head's vascular supply:
\_\_: medial 1/3 cortex superiorly (x occipital)
\_\_: lateral 2/3 cortex (x occipital)
\_\_: visual centers posteriorly
\_\_: supplies: Basal Ganglia

Answer 23

ACA
MCA
PCA
anterior, middle, posterior cerebral arteries
Lenticulostriate supplies basal ganglia

Question 24

MCA Infarct causes:

Answer 24

think R face/arm paresis/plegia

Question 25

PCA infarct causes:

Answer 25

think R hemianopsia (decreased vision or blindness takes place in half the visual field of one or both eyes)

Question 26

Basal Ganglia infarct causes:

Answer 26

think left hemiparesis (weakness on one side of the body)