Stroke

Question 1

ACA stroke

Answer 1

Contralateral lower extremity weakness
Contralateral lower extremity sensory loss

Frontal lobe behavior abnormalities
Return of infantile reflexes

Left ACA= transcortical aphasia
Right ACA = L hemineglect

Question 2

MCA stroke

Answer 2

contralateral arm and face weakness
Contralateral arm and face sensory loss

Contralateral homonymous hemianopsia

L MCA= brocas, wernickes, global aphasia

R MCA= L hemineglect

Question 3

PCA stroke

Answer 3

Contralateral homonymous hemianopia

Larger inks to the thalamus/internal capsule : hemi sensory loss and hemiplegia

L PCA- alexia without agraphia; aphasia ( larger infarcts)

Question 4

Brainstem strokes four D’s

Answer 4

dysphagia
dysarthria
diplopia
dysmetria

Question 5

cerebellar stroke symptoms are always

Answer 5

Ipsilateral to location of the infarct

Question 6

cerebellar hemispheres control

Answer 6

extremities

Question 7

vermis/floculonodular lobe control

Answer 7

midline of body

Question 8

main symptom of cerebellar stroke

Answer 8

ataxia
May also have brainstem signs

Question 9

superior cerebellar artery stroke symptom

Answer 9

pure unilateral ataxia

Question 10

AICA stroke symptom

Answer 10

unilateral deafness and ataxia

Question 11

PICA symptoms

Answer 11

brainstem signs and ataxia

Question 12

types of stroke

Answer 12

transient ischemic attack- warning sign

hemorrhagic- bleeding/bad symptoms initially but good progress prognostically

ischemic-blood supply is cut off from brain

Question 13

modifiable risk factors for stroke- medical

Answer 13

blood pressure
Cardiac disease
Hypercholesterolemia
Diabetes
History of TIA

Question 14

FAST

Answer 14

F- facial weakness

A- arm weakness

S- speech difficulties

T- time is critical

Question 15

ischemic penumbra

Answer 15

surrounding ischemic areas
Cells receive enough oxygen to remain alive for a limited time
Can be salvaged

protect the penumbra by increasing oxygen transport through surgery or medication

Question 16

infarcted core

Answer 16

severe local ischemia
Tissue necrosis

Question 17

f-tPA

Answer 17

recombinant tissue plasminogen activator

Clot Buster

Question 18

when pt is a candidate for clot buster

Answer 18

onset is less than six hours
CT negative for hemorrhage
Not anticoagulated INR is less than 1.5

Keep blood pressure less than 185/110
hours since onset
<3 hours- IV TPA is substantial
3-4.5 hours - iv tPA moderate
4.5-6 hours - intra arterial tPA moderate

Question 19

when pt is not candidate for clot buster

Answer 19

keep bp <220/120
aspirin 325 mg chewed
DVT prophylaxis
-Heparin 5000 SQ BID