CVA

Question 1

What are the big risk factors for CVA?

Answer 1

Hypertension
Hyperlipidemia
Tobacco use
Diabetes
Race (black and african americans are more at risk)
Oral birth control
Age
Gender
Sickle cell
History of TIA
A-fib

Question 2

What is an ischemic stroke?

Answer 2

An occlusion of a cerebral artery

Question 3

What types of patients are in a relatively hypercoagulable state and have an increased risk of thrombus formation causing a stroke?

Answer 3

Patients taking chemo or oral contraceptives

Question 4

What is penumbra?

Answer 4

Ischemic area that is still viable (injured by alive)

Question 5

What is the goal related to penumbra?

Answer 5

Salvage the penumbra within 3 hours because otherwise it will die

Question 6

What is a hemorrhagic stroke?

Answer 6

Bleeding within the brain parenchyma

Question 7

What is the prognosis for a hemorrhagic stroke?

Answer 7

If the patient is older - the prognosis is better because the brain naturally atrophies and can make more room.
Depends on the location and size
How quickly the bleed shows up on a screen

Question 8

What type of hematoma is seen commonly with skull fractures?

Answer 8

Epidural hematoma

Question 9

What type of blood is involved with an epidural hematoma?

Answer 9

Arterial (oxygenated) blood

Question 10

What is the dura mater doing with an epidural hematoma?

Answer 10

Peeled off of the skull

Question 11

What type of blood is involved with a subdural hematoma?

Answer 11

Venous blood (deoxygenated)

Question 12

What is the onset of subdural hematomas?

Answer 12

Can be 2-10 days

Question 13

Are epidural or subdural hematomas more severe?

Answer 13

Subdural hematomas

Question 14

What is a subarachnoid hemorrhage?

Answer 14

Bleed between the outer arachnoid membrane and the pia mater

Question 15

What type of stroke is suspected with the complaint of “the worst headache of my life”?

Answer 15

Hemorrhagic stroke

Question 16

What presentation may indicate irritation of the meninges?

Answer 16

Nuchal rigidity and photophobia

Question 17

With what type of brain hemorrhage will you see blood within CSF in a lumbar puncture?

Answer 17

A subarachnoid hemorrhage

Question 18

What are management techniques for caring for a patient with a subarachnoid hemorrhage?

Answer 18

Bedrest with sedation
Tight BP management
Surgical clipping ASAP
Prophylactic anticonvulsant
Nimodipine
Pressors + colloids

Question 19

When is the re-bleeding risk for a subarachnoid hemorrhage the highest?

Answer 19

The first 24 hours

Question 20

What is the acronym for recognizing a stroke?

Answer 20

BE FAST
B = balance
E = eyes
F = face
A = arms
S = speech
T = time

Question 21

What type of imaging should be used for a stroke?

Answer 21

CT without contrast to exclude hemorrhage, if acute stage = MRI

Question 22

What are the consequences of a stroke?

Answer 22

Depends on the area of damage
Motor / sensory deficit
Flaccidity (weakness)
Spasticity
Visual disturbances
Aphasia
Depression
Memory problems
Behavioral problems

Question 23

What is aphasia?

Answer 23

Some degree of inability to speak or to comprehend

Question 24

What is dysphagia?

Answer 24

Impairment of speech

Question 25

What is dysarthria?

Answer 25

Imperfect speech sounds

Question 26

What is expressive aphasia?

Answer 26

Comprehension intact but cannot express

Question 27

What is receptive aphasia?

Answer 27

Can communicate but cannot comprehend what is being said

Question 28

What are common behavioral problems after a stroke?

Answer 28

Increased emotional responsiveness
May underestimate own ability
Slow reaction time
Hesitant and cautious
May be apathetic, confused, and disoriented