Vascular

Question 1

Cerebral blood flow in penumbra - neuronal dysfunction

Answer 1

20-40ml/100g per minute

Question 2

What is the normal cerebral blood flow

Answer 2

50-60ml/100g per minute

Question 3

What is the blood flow at irreversible cellular damage

Answer 3

<10-15ml/100g per minute

Question 4

Part of mechanism of cell death in ischemic stroke

Answer 4

Activation of caspase (cysteine-a spastic protease/cysteine aspartase)

Question 5

Size of lacunar infarction

Answer 5

<15 mm (typically 3-20) mostly 10mm

Question 6

Most common site of spinal cord infarction

Answer 6

Lumbosacral

Question 7

Most vulnerable site of spinal cord infarction (hypoperfusion-cardiac arrest/cardiac bypass surg)

Answer 7

Mid-thoracic segments (T5-T8)

Question 8

Risk of stroke in AFIB patients

Answer 8

5- fold increase (15-20%)

Question 9

How much does a single anti platelet decrease the risk of stroke in AFIB patient

Answer 9

Decrease by 20%

Question 10

How much does a single warfarin decrease the risk of stroke in AFIB patient

Answer 10

Decrease the risk by 60%

Question 11

Only 2 NOACs showed superiority compared to warfarin in preventing stroke in AF

Answer 11

Dabigatran 150mg and apixaban

Question 12

Highest risk of recurrence of stroke in young

Answer 12

Moyamoya disease

Question 13

Genetics of moyamoya disease

Answer 13

Familial form (15%): AD Ch17

Question 14

Moyamoya location

Answer 14

Stenosis in supraclinoid segment of ICA

Question 15

Most common dissection location

Answer 15

Extra-cranial ICA (c1-c2) or extra-cranial vertebral

Question 16

Most common FMD locations

Answer 16

1- renal artery
2-iliac and carotid (extra-cranial, bilateral in 65%)
3-subclavian and vertebral

Question 17

Most common location of ICH in moyamoya

Answer 17

Paraventricular: BG and thalamus

Question 18

What is the gold standard of diagnosis of CADASIL

Answer 18

NOTCH-3 on CH19

Question 19

Most common modifiable risk factor in stroke

Answer 19

HTN

Question 20

Most common cause of death in stroke

Answer 20

Pneumonia and sepsis

Question 21

MOA of clopidogrel and ticagrelor

Answer 21

Adenosine diphosphate receptor inhibitor

Question 22

SE of dipyridamole

Answer 22

Headache and GI side effects

Question 23

Percent of cryptogenic stroke in young out of all causes

Answer 23

40%

Question 24

MCC of stroke in young

Answer 24

Carotid dissection

Question 25

Least risk of hemorrhage in vascualr malformations

Answer 25

Venous Angioma/ developmental venous anomaly

Question 26

Highest risk of hemorrhage in vascular malformations

Answer 26

AVM

Question 27

Most common initial symptoms in cavernous malformations

Answer 27

Seizures

Question 28

Most common type of vascular malformation

Answer 28

Venous angioma

Question 29

MCC of spontaneous ICH in elderly

Answer 29

HTN

Question 30

2nd MCC of spontaneous ICH in elderly

Answer 30

CAA

Question 31

MCC of SAH

Answer 31

Trauma

Question 32

MCC of spontaneous SAH

Answer 32

Aneurysm rupture

Question 33

Most common electrolyte imbalance in SAH

Answer 33

HypoNa (30%)

Question 34

Most common non-neurological complication in SAH

Answer 34

Fever 70%

Question 35

Treatment of cerebral vasospasm

Answer 35

Triple H therapy: (first line)
1-Hypertension: norepinephrine
2-Hypervolemia : IV fluids
3-Hemodilution

-intra-arterial vasodilator: Ca channel inhibitor: nicardipine, verapamil

Question 36

Most common location in SDH

Answer 36

Parietal and frontal convexities

Question 37

Percent of correlation between spot sign on CTA and expansion of hematoma

Answer 37

75% (predictive of hematoma expansion)

Question 38

Most effective in rapid lowering of ICP

Answer 38

Hyperventilation (achieving hypocapnia 25-30)