NRSRGRY - CVD

Question 1

What is the most frequent cause of new, rapid onset, non-traumatic neurologic deficit

Answer 1

CVD

Question 2

Risk factors of CVD (4)

Answer 2

DHHS
Diabetes
High Cholesterol
High BP
Smoking

Question 3

Mechanisms of CVD (3)

Answer 3

Atheroma
Endothelial damage
Weakening of vessel wall

Question 4

Hypodensity on CT

a. Ischemic
b. Hemorrhagic

Answer 4

Ischemic

Hemorrhagic is hyperdensity

Question 5

Clot forms in the vessel wall and occludes a vessel. What type of CVD is this?

Answer 5

Thrombotic Ischemic disease

Question 6

Clot is elsewhere, thrown distally and lodges into vessel and occludes. What type of CVD?

Answer 6

Embolic Ischemic disease

Question 7

Hemorrhagic diseases (4)

Answer 7

CHAA

Cerebral aneurysm
Hypertension
Amyloid Angiopathy
Ateriovenous malformation

Question 8

Ischemic disease accounts for what percentage of acute CVD?

Answer 8

85%

Question 9

T about stroke EXCEPT

a. symptoms will vary based on the functions of the neural tissues supplied by the occluded vessel and the presence of collateral circulation
b. occlusion proximal to the circle of willis will generally result in a stroke.
c. Neurologic deficit is always permanent
d. A and B
e. B and C

Answer 9

E

Question 10

ACA stroke lobe involvement

Answer 10

medial frontal and parietal lobes

Question 11

ACA stroke neuro deficits

Answer 11

contralateral leg weakness

Question 12

MCA lobe involvement

Answer 12

lateral, frontal, temporal and parietal lobes

Question 13

MCA stroke neuro deficits

Answer 13

contralateral face and arm weakness, language deficits

Question 14

Other effects of proximal MCA stroke (aside from neurodeficits)

Answer 14

intracranial mass effect and midline shift

Question 15

PCA stroke lobe involvement

Answer 15

occipital lobe

Question 16

Effect of R PCA stroke

Answer 16

L homonymous hemianopia

Question 17

PICA stroke lobe involvement

Answer 17

lateral medulla, inferior half of the cerebellar hemispheres

Question 18

Effect of PICA stroke

Answer 18

nausea
vomiting
nystagmus
dysphagia
ipsilateral Horner's syndrome
Ipsilateral limb ataxia

Question 19

Horner’s syndrome

Answer 19

Miosis
Ptosis
Anhidrosis

Question 20

infarction, or stroke, occurs in the lateral medulla.
Symptoms:

hoarseness
nausea
vomiting
hiccups
rapid eye movements, or nystagmus
a decrease in sweating
problems with body temperature sensation
dizziness
difficulty walking
difficulty maintaining balance

Answer 20

Wallenburg syndrome

Question 21

Management of embolic disease: reopening of occluded vessel via what drug?

Answer 21

rTPA

Question 22

Life-saving surgery for patients with embolic disease who had stroke?

Answer 22

Decompressive hemicraniectomy or suboccipital hemicraniectomy

Question 23

L hemiplegia, what artery affected?

Answer 23

R MCA

Question 24

Causes of hemorrhagic CVD

Answer 24

Hypertension
Amyloid angiopathy
AVM
ANeurysm
Venous thrombosis
Hemorrhagic conversion of ischemic infarct
fungal infections

Question 25

Where does hemorrhagic stroke typically occur?

Answer 25

Basal ganglia or cerebellum

Question 26

Most hypertensive hemorrhages are medically managed EXCEPT for

Answer 26

patients with clot <1cm from the cortical surface

Question 27

R sided weakness, headache, vomiting a few hours PTA,

Answer 27

L Basal ganglia hemorrhage

Question 28

amyloid deposition in the media of small cortical vessels.

Answer 28

Amyloid angiopathy

Question 29

Focal dilatation of the vessel wall (balloon-like outpouching/fusiform)

Answer 29

Cerebral aneurysm

Question 30

Where does cerebral aneurysm usually occur

Answer 30

branch points of major bessels

Question 31

Thin-walled rupture of cerebral aneurysm cause

Answer 31

subarachnoid hemorrhage

Question 32

Describe the headache of cerebral aneurysm

Answer 32

Thunderclap headache, worst headache of my life

Question 33

Management of Cerebral aneurysm

Answer 33

``` Cranial CT Four-vessel cerebral angiography Early aneurysm occlusion Craniotomy, clipping Endovascular, coiling ```

Question 34

Approximate mortality rate of cerebral aneurysm

Answer 34

50% in the first month

Question 35

Approximately ___ of survivors return to pre-SAH function

Answer 35

1/3

Question 36

____ of survivors have moderate to severe disability

Answer 36

2/3

Question 37

Abnormal dilated arteries and veins without an intervening capillary bed

Answer 37

AVM

Question 38

AVM presents with (3)

Answer 38

SAH intraparenchymal hemorrhage seizures

Question 39

Hemorrhage rate of AVM

Answer 39

2-4% in a year

Question 40

treatment of AVM

Answer 40

``` microsurgical excision endovascular embolization stereotactic radiosurgery (<3cm diameter) ```