stroke treatment

Question 1

what is thee preferred stroke assessment tool ?

Answer 1

NIHSS

Question 2

ICH what is the best imaging modality ?

Answer 2

non contrast CT or MRI

Question 3

what is a wake up stroke ?

Answer 3

an ischemic stroke associated with the onset of neurological symptoms upon waking up

Question 4

what test must bee done before the administration of IV ateplase ?

Answer 4

blood glucose levels

Question 5

what is the BP goal before the administration of ateplase ?

Answer 5

dont lower unless exceeding 220/120 , in that case lower by 15% and maintain it above 1880/110

Question 6

how should BP be lowered before ateplase administration ?

Answer 6

labetalol or niardipinee

Question 7

if there is resistant hypertension what should b used ?

Answer 7

IV sodium nitroprusside

Question 8

how often should the BP be monitored ?

Answer 8

every 15 minutes for 2 hours after starting treatment
every 30 minutes for 6 hours for 16 hours

Question 9

what is the dose of aletplasee used ?

Answer 9

0.9 mg over 60 minutes

Question 10

what precautions must be taken when dealing with cerebral micro bleeds and ateplase ?

Answer 10

more than 10 micro bleeds then avoid ateplase

Question 11

what other drugs should b avoid with ateplase ?

Answer 11

avoid abciximiab with it
a patient treated with LMWH in the past 24 hours
no aspirin within 90 minutes

Question 12

when are antithrombotics given in relation to ateplase ?

Answer 12

24 hours after infusion

Question 13

what substitution can be used for patients undergoing mechanical thrombolectomy ?

Answer 13

tenecteplase

Question 14

alternative of altplase for minor symptoms ?

Answer 14

iv bolus tenecteplase

Question 15

what are the indications for mechanical thrombolectomy ?

Answer 15

premodified rankin scale of 0 to 1
above 18 years old
NIHSS score 6 or higher
ASPECTS 6 or higher

Question 16

what should be done for secondary stroke prevention ?

Answer 16

dual anti platelet therapy ( aspirin and clopidogrel ) within 24 hours of a minor stroke
not anti coagulants
avoid triple anti platelet therapy

Question 17

what is the recommend treatment for high risk patients for treatment of hyperlipidemia ?

Answer 17

maximum dose tolerated of statins combined with ezetimibe

Question 18

what are the post stroke complications ?

Answer 18

acute reperfusion injury
symptomatic intracranial haemorrhage
malignant cerebral oedema
infection
venous thromboembolism
dysphagia and nutritional consideration

Question 19

what is the clinical picture of acute reperfusion injury ?

Answer 19

orolingual angioedema

Question 20

what is the treatment for acute reperfusion injury

Answer 20

stop the transfusion then give anti histamines, iv corticosteroids, epinephrine and intubate the patient

Question 20

what is thee treatment for symptomatic intracranial haemorrhage ?

Answer 20

cryopercipitatee
IV tranexeemic acid.
IVv aminocarpoic aciid

Question 21

what is the best treatment for malignant cerebral oedema ?

Answer 21

surgical decompression with DHC
mannitol or HTS

Question 22

when does VTE peak post stroke ?

Answer 22

day 2 to 7

Question 23

how is early dysphasia screening done post stroke ?

Answer 23

water swallowing test

Question 24

how is short term vs long term feeding achieved post stroke ?

Answer 24

short term : nasogastric tube
long term : percutaneous endoscopic gastrostomy tube

Question 25

what is thee most common cause of fever in the first 48 hours after an acute stroke ?

Answer 25

pneumonia

Question 26

what effect on breathing do bihemispheric strokes have ?

Answer 26

chayne-strokes respiration

Question 27

what anti depressant can be used post stroke ?

Answer 27

fluoxetine

Question 28

what are the most common causes of haemorrhagic stroke ?

Answer 28

AVM
hypertension
aneurysm

Question 29

when can wee opt for non surgical treatment of haemorrhagic stroke ?

Answer 29

if the ICH volume is less than 10

Question 30

what are the indications for surgery in haemorrhagic stroke ?

Answer 30

cerbellar hge more than 3 cms
young patients with lobar haemorrhage