strokes

Question 1

cx haemorrhagic stroke

Answer 1

Head injuries.
Cerebral aneurysm.
amyloid angioapathy
sympathomimetic drugs such as cocaine cause high BP
aneurysm
anticogaulants
Blood vessel abnormalities, such as arteriovenous malformation (AVM) or amyloid angiopathy.
Blood or bleeding disorders, such as sickle cell anemia.
Liver disease.
Brain tumor.
Drug abuse.

Question 2

cx of ischaemic

Answer 2

artheroclerosis - cx by high BP, high cholesterol or diabetes.
smoking and obesity
small vessel disease - become narroed reducing blood flow can lead to dementia
AF - heart does not empty itself - cardioembolism
patent foramen ovale - thrombus to brain- venous clot
arterial dissection - dmage to artery
hypercoagulable state
vasospasm of structurally normal vessels eg sympothetic drug use eg amphetamines and cocaine

Question 3

define

Answer 3

sudden onset, focal deficit particuallry if they have a vascular risk facotr with or without evidence of ischaemia or haemorrhage

Question 4

what do you give to treat thrush

Answer 4

nystatin

Question 5

dehydration check what

Answer 5

blood urea and creatinine ratio

Question 6

what is the corona radiata

Answer 6

The corona radiata refer to a pair of white matter tracts seen at the level of the lateral ventricles.

Question 7

left sided fixed eye gaze where is lsesion

Answer 7

left side

Question 8

best way to decide what laxative to give

Answer 8

PR exam
soft - stimulant to help come
hard - stool softner such as macogol
v hard may need enema

Question 9

meinigits test with chin

Answer 9

chin to chest ellicit pain

Question 10

intermittent pneumatic compression

Answer 10

prevent DVT in hospital

Question 11

post fall - leave on anticogaulant why

Answer 11

becaue you dont want them to get a stroke - remmeber that

Question 12

post fall - leave on anticogaulant why

Answer 12

becaue you dont want them to get a stroke - remmeber that

Question 13

hypertensive strokes most ocmmonly occur where

Answer 13

deep in basal ganglia or deep in the brainstem

Question 14

young stroke bloods

Answer 14

24 urine catecholamines and cortisol
ANCA
vasculitis
diabetes

Question 15

bezafibrate

Answer 15

after statin good at reducing triglyceride but variable LDL affect

Question 16

features of bells palsy

Answer 16

Acute (but not sudden) onset, unilateral, lower motor neuron facial weakness, sparing the extraocular muscles and muscles of mastication.
Mild-moderate postauricular otalgia (which may precede paralysis).
Hyperacusis (actually quite uncommon).
Nervus intermedius symptoms (altered taste and dry eyes/mouth).

ramsey hunt will have rash

give oral pred
otoscopy to rule out ramsey hunt syndrome

Question 17

is the pupil dilated in third nerve palasy

Answer 17

yes
constricted in horners

Question 18

what palsy associated with horner

Answer 18

klumpke

Question 19

thrombectomy can be performed within how mnay hours

Answer 19

6 hours

altepase 4.5

Question 20

less dense brain tissue so more black when

Answer 20

brain tissue had died

Question 21

ypunger stroke patietn

Answer 21

patent ovale - bending down as increase right heart pressure casuing stroke

Question 22

when should you review a patients medication

Answer 22

if over 75 annually
if on 4 or more drugs every 6 months