Stroke

Question 1

BP thershold for giving TPA?

Answer 1

<185/110

Question 2

BP thresholf after TPA given?

Answer 2

<180/105

Question 3

when to give chemoprophylaxis after hemorrhagic stroke?

Answer 3

after day 2

Question 4

time frame to give TPA?

Answer 4

within 4.5 hours

Question 5

BP threshold for ischemic CVA that did not get TPA?

Answer 5

<220/120

Question 6

when to give AC after embolic CVA?

Answer 6

after 48h

Question 7

percent of post TPA significatn bleed?

Answer 7

6%

Question 8

rate of spontaneous bleed post ichemic CVA?

Answer 8

25%

Question 9

goal SBP for ICH?

Answer 9

SBP <160

Question 10

loss of pain and temp on ipsi face and contralateral body?

Answer 10

Wallenberg syndrome- medulla specifically PICA and vert

Question 11

locked in syndrome stroke where? eye movements?

Answer 11

pons/vertical and blinking

Question 12

contralateral leg weakness and abulia, CVA where?

Answer 12

ACA

Question 13

contralateral symptoms with ipsilateral eye gaze, CVA where?

Answer 13

MCA

Question 14

CT perfusion blue/black?

Answer 14

blue is at risk tissue and black is already infarcted

Question 15

ASPECTS score grading?

Answer 15

higher the score the smaller core infarct, more amenable to thrombectomy

Question 16

timing of thrombectomy with stentriever?

Answer 16

within 6-12 hours of onset

Question 17

candidate for thrombectomy?

Answer 17

small core, proximal occlusion, within 6-12 hours of sx onset

ASPECTS >6
NIH >6

Question 18

when to do DHC?

Answer 18

large MCA distribution infarct within 48 hours of swelling symptoms

Question 19

meds that cause RPLS?

Answer 19

cyclosporine, tacrolumis

Question 20

TPA CI?

Answer 20

recent major surgery, AC with INR>1.7, CVA or head trauma within last 3 months, thrombocytopenia, uncontrolled HTN, hx of ICH

Question 21

TPA benefits?

Answer 21

no mortality benefit but increases likelihood of independence

Question 22

timeframe for TPA?

Answer 22

4.5h from LKW

Question 23

chance of bleeding from TPA?

Answer 23

6%

Question 24

medications to use to treat hemodynamically unstable brain dead organ donors?

Answer 24

synthroid, vasopressin is first line vasopressor

Question 25

hemodynamic parameters in brain dead donors?

Answer 25

goal UOP 1 cc/kg/hr using crystalloid, MAP >60

Question 26

mechanism of valproate induced hyperammonemia

Answer 26

metabolites inhibit N acetyl glutamate synthetase which is a rate limiting step in the urea cycle

Question 27

left ACA sx?

Answer 27

mutism and transcortical motor aphasia

Question 28

right ACA sx?

Answer 28

hemineglect

Question 29

nitroprusside effects around stroke?

Answer 29

cerebral vasodilation causing inc ICP and in CBV

Question 30

damange to what 3 areas can cause coma?

Answer 30

RAS, bilateral temporal lobes, bilateral frontal lobes

Question 31

damage to pons can cause what?

Answer 31

locked in syndrome