Stroke ; Lecture

Question 1

What is the World Health Organization (WHO) definition of stroke?

Answer 1

A clinical syndrome characterized by rapidly developing signs of focal (or global) disturbance of cerebral function lasting >24 hours or leading to death, with no apparent cause other than vascular origin.

Question 2

A transient ischemic attack (TIA) is defined as neurological symptoms lasting _________ with no evidence of infarction on imaging.

Answer 2

<24 hours.

Question 3

True/False: Stroke is the second leading cause of death worldwide.

Answer 3

True

Question 4

Match the stroke subtype with its description:

Ischemic stroke.
Hemorrhagic stroke.
TIA.

Answer 4

Ischemic stroke: Caused by arterial occlusion.
Hemorrhagic stroke: Bleeding into brain tissue or subarachnoid space.
TIA: Temporary focal neurological symptoms with no infarction.

Question 5

Name five modifiable risk factors for stroke.

Answer 5

Hypertension.
Diabetes mellitus.
Smoking.
Hyperlipidemia.
Atrial fibrillation.

Question 6

_________ is the single most important modifiable risk factor for stroke.

Answer 6

Hypertension.

Question 7

True/False: Age, male gender, and a family history of stroke are non-modifiable risk factors.

Answer 7

True.

Question 8

What are the two main mechanisms of ischemic stroke?

Answer 8

Embolism (e.g., from the heart in AF).
Thrombosis (e.g., large artery atherosclerosis).

Question 9

In hemorrhagic stroke, bleeding causes _________, which leads to increased intracranial pressure and subsequent neurological damage.

Answer 9

mass effect.

Question 10

True/False: The ischemic penumbra is the area of potentially salvageable tissue around the infarct core.

Answer 10

True.

Question 11

What are common symptoms of stroke based on vascular territory?

Answer 11

MCA stroke: Hemiparesis, aphasia, neglect.
ACA stroke: Leg weakness, abulia.
PCA stroke: Visual field defects.
Basilar artery stroke: Locked-in syndrome.

Question 12

Dysphasia occurs in _________ hemisphere strokes, while neglect is more common in _________ hemisphere strokes.

Answer 12

dominant; non-dominant.

Question 13

True/False: Sudden onset severe headache is a hallmark of ischemic stroke.

Answer 13

False (suggests hemorrhagic stroke or SAH).

Question 14

What is the first-line imaging modality for stroke?

Answer 14

Non-contrast CT brain.

Question 15

MRI with _________ is highly sensitive for detecting acute ischemic changes.

Answer 15

diffusion-weighted imaging (DWI).

Question 16

True/False: A CT angiogram (CTA) can identify large vessel occlusions and guide thrombectomy decisions.

Answer 16

True.

Question 17

What are the acute treatments for ischemic stroke?

Answer 17

IV thrombolysis with alteplase (if within 4.5 hours).
Endovascular thrombectomy (for large vessel occlusions up to 24 hours).
Aspirin 300 mg (after exclusion of hemorrhage).

Question 18

Hemorrhagic stroke management focuses on _________ control and reducing _________ pressure.

Answer 18

blood pressure; intracranial.

Question 19

True/False: Anticoagulation is contraindicated in hemorrhagic stroke.

Answer 19

True.

Question 20

What secondary prevention strategies are used after a stroke?

Answer 20

Antiplatelets (e.g., aspirin, clopidogrel).
Blood pressure control.
Statins.
Lifestyle modification (e.g., smoking cessation, diet).

Question 21

What are common complications of stroke?

Answer 21

Aspiration pneumonia.
DVT/PE.
Pressure ulcers.
Post-stroke depression.
Seizures.

Question 22

The risk of recurrence is highest in the first _________ days after a stroke.

Answer 22

30

Question 23

True/False: Early rehabilitation improves outcomes in stroke patients.

Answer 23

True.

Question 24

A 65-year-old man presents with right-sided weakness, slurred speech, and facial droop. Non-contrast CT shows no bleed. What is the next step?

Answer 24

Consider thrombolysis if within 4.5 hours and no contraindications.

Question 25

A 50-year-old woman presents with sudden severe headache, vomiting, and neck stiffness. CT shows blood in the subarachnoid space. What is the likely diagnosis?

Answer 25

Subarachnoid hemorrhage (SAH).