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SRGRY3 > NRSRGRY - CVD > Flashcards

NRSRGRY - CVD Flashcards

1
Q

What is the most frequent cause of new, rapid onset, non-traumatic neurologic deficit

A

CVD

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2
Q

Risk factors of CVD (4)

A 
DHHS
Diabetes
High Cholesterol
High BP
Smoking
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3
Q

Mechanisms of CVD (3)

A

Atheroma
Endothelial damage
Weakening of vessel wall

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4
Q

Hypodensity on CT

a. Ischemic
b. Hemorrhagic

A

Ischemic

Hemorrhagic is hyperdensity

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5
Q

Clot forms in the vessel wall and occludes a vessel. What type of CVD is this?

A

Thrombotic Ischemic disease

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6
Q

Clot is elsewhere, thrown distally and lodges into vessel and occludes. What type of CVD?

A

Embolic Ischemic disease

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7
Q

Hemorrhagic diseases (4)

A

CHAA

Cerebral aneurysm
Hypertension
Amyloid Angiopathy
Ateriovenous malformation

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8
Q

Ischemic disease accounts for what percentage of acute CVD?

A

85%

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9
Q

T about stroke EXCEPT

a. symptoms will vary based on the functions of the neural tissues supplied by the occluded vessel and the presence of collateral circulation
b. occlusion proximal to the circle of willis will generally result in a stroke.
c. Neurologic deficit is always permanent
d. A and B
e. B and C

A

E

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10
Q

ACA stroke lobe involvement

A

medial frontal and parietal lobes

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11
Q

ACA stroke neuro deficits

A

contralateral leg weakness

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12
Q

MCA lobe involvement

A

lateral, frontal, temporal and parietal lobes

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13
Q

MCA stroke neuro deficits

A

contralateral face and arm weakness, language deficits

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14
Q

Other effects of proximal MCA stroke (aside from neurodeficits)

A

intracranial mass effect and midline shift

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15
Q

PCA stroke lobe involvement

A

occipital lobe

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16
Q

Effect of R PCA stroke

A

L homonymous hemianopia

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17
Q

PICA stroke lobe involvement

A

lateral medulla, inferior half of the cerebellar hemispheres

18
Q

Effect of PICA stroke

A 
nausea
vomiting
nystagmus
dysphagia
ipsilateral Horner's syndrome
Ipsilateral limb ataxia
19
Q

Horner’s syndrome

A

Miosis
Ptosis
Anhidrosis

20
Q

infarction, or stroke, occurs in the lateral medulla.
Symptoms:

hoarseness
nausea
vomiting
hiccups
rapid eye movements, or nystagmus
a decrease in sweating
problems with body temperature sensation
dizziness
difficulty walking
difficulty maintaining balance
A

Wallenburg syndrome

21
Q

Management of embolic disease: reopening of occluded vessel via what drug?

A

rTPA

22
Q

Life-saving surgery for patients with embolic disease who had stroke?

A

Decompressive hemicraniectomy or suboccipital hemicraniectomy

23
Q

L hemiplegia, what artery affected?

A

R MCA

24
Q

Causes of hemorrhagic CVD

A 
Hypertension
Amyloid angiopathy
AVM
ANeurysm
Venous thrombosis
Hemorrhagic conversion of ischemic infarct
fungal infections
25
Q

Where does hemorrhagic stroke typically occur?

A

Basal ganglia or cerebellum

26
Q

Most hypertensive hemorrhages are medically managed EXCEPT for

A

patients with clot <1cm from the cortical surface

27
Q

R sided weakness, headache, vomiting a few hours PTA,

A

L Basal ganglia hemorrhage

28
Q

amyloid deposition in the media of small cortical vessels.

A

Amyloid angiopathy

29
Q

Focal dilatation of the vessel wall (balloon-like outpouching/fusiform)

A

Cerebral aneurysm

30
Q

Where does cerebral aneurysm usually occur

A

branch points of major bessels

31
Q

Thin-walled rupture of cerebral aneurysm cause

A

subarachnoid hemorrhage

32
Q

Describe the headache of cerebral aneurysm

A

Thunderclap headache, worst headache of my life

33
Q

Management of Cerebral aneurysm

A 
Cranial CT
Four-vessel cerebral angiography
Early aneurysm occlusion
Craniotomy, clipping
Endovascular, coiling
34
Q

Approximate mortality rate of cerebral aneurysm

A

50% in the first month

35
Q

Approximately ___ of survivors return to pre-SAH function

A

1/3

36
Q

____ of survivors have moderate to severe disability

A

2/3

37
Q

Abnormal dilated arteries and veins without an intervening capillary bed

A

AVM

38
Q

AVM presents with (3)

A

SAH
intraparenchymal hemorrhage
seizures

39
Q

Hemorrhage rate of AVM

A

2-4% in a year

40
Q

treatment of AVM

A 
microsurgical excision
endovascular embolization
stereotactic radiosurgery (<3cm diameter)

SRGRY3 (44 decks)

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