USMLE stuff

Question 1

Sx of posterior circulation strokes

Answer 1

the 4Ds
Diplopia
Dizziness
Dysphagia
Dysarthria

Question 2

Sx of MCA stroke

Answer 2

cause CHANGes:
Contralateral paresis and sensory loss in the face and arm
Homonymous hemianopia
Aphasia (dominant)
Neglect (nondominant)
Gaze preference toward the side of the lesion

Question 3

Contraindications to tPA therapy

Answer 3

SAMPLE STAGES
Stroke or head trauma within the last three months
Anticoagulation with INR > 1.7 or prolonged PTT
MI (recent)
Prior intracranial hemorrhage
Low platelet count (< 100,000/mm3)
Elevated BP: Systolic > 185 or diastolic BP > 110
Surgery in the past 14 days

TIA (mild symptoms or rapid improvement of symptoms)
Age < 18
GI or urinary bleeding in the past 21 days
Elevated (> 400) or ↓ (< 50 mg/dL) blood glucose
Seizures present at the onset of stroke

Question 4

conditions associated with berry aneurysms

Answer 4

Conditions associated with berry aneurysms
that can MAKE an SAH more likely:

Marfan’s syndrome
Aortic coarctation
Kidney disease (autosomal dominant, polycystic)
Ehlers-Danlos syndrome

Sickle cell anemia
Atherosclerosis
History (familial)