Stroke

Question 1

Order of imaging in acute ischemic stroke

Answer 1

Non-contrast CT head (rule out bleed)

CT angiogram (eval for proximal occlusion)

CT perfusion (eval for penumbra)

Question 2

What is the dose of TPA for ischemic stroke

Answer 2

0.9 mg/kg max 90 mg

Question 3

4 criteria to contraindicate TPA from 3-4.5 hrs

Answer 3

Age > 80
NIHSS > 25
Any oral anticoagulation regardless of labs
HO diabetes with prior stroke

Question 4

Requirements for consideration for endovascular intervention for stroke

Answer 4

6-24 hrs from onset

NIHSS > 10

Proximal vessel occlusion

Mismatch in amount of symptoms for infarcted size on imaging

Question 5

When to start aspirin in ischemic stroke

Answer 5

24 hours after interventions

Question 6

Who gets clopidogrel following ischemic stroke

Answer 6

TIA or NIHSS < 3

Question 7

Ideal glucose range for patients with ischemic stroke

Answer 7

140-180

Question 8

SBP goal prior to TPA

Answer 8

< 185

Question 9

SBP after TPA

Answer 9

< 180

Question 10

SBP goal without TPA in stroke

Answer 10

< 220

Question 11

Differentiation of seizure vs stroke based off eye deviation

Answer 11

Eyes away from the hemiparesis (toward the lesion) = stroke

Eyes toward the hemiparesis (toward the lesion) = seizure