Stoke

Question 1

Sudden loss of neurological function as the result of disruption to blood flow resulting in tissue death

Answer 1

CVA

Question 2

Types of CVA

Answer 2

Ischemic

Hemorrhagic

Question 3

Risk factors We can control

Answer 3

HTN (>160/95)
Smoking
Hyperlipidemia (fat)

Question 4

If your diastolic lowers by 5-6 mmHg, how much does risk of CVA decrease

Answer 4

40%

Question 5

What are risk factors we cannot control

Answer 5

Age
Sex (Male>females)
Hereditary
Race (AA>caucasian)
Geography

Question 6

Signs of Stroke

Answer 6

Numbness
Difficulty speaking
Trouble seeing
Ataxia
Headache

Question 7

Acronym FAST… for getting there ASAP

Answer 7

Facial droop
Arm weakness
Speech Difficulties
Time

Question 8

How are Strokes Dx

Answer 8

Non-contrast CAT scan
MRI
MRA
EKG
Echo
TEE
Telemetry
Carotid Doppler

Question 9

What results in lysis of fibrin?

Answer 9

tPA

Question 10

What is tPA? And what is it used with?

Answer 10

Tissue Plasminogen Activator

Ischemic Strokes

Question 11

What is the predictor for stroke after Transient Ischemic Attack?

Answer 11

U of Oxford ABCD scale

Question 12

What does ABCD scale stand for

Answer 12

Age
BP
Clinical Features
Duration

Question 13

Standardized tool to assess impairment from stroke

Answer 13

NIH Stroke Scale

To assess if tPA needed

Question 14

When is NIH Stroke scale performed?

What is the max score>?

Answer 14

Baseline
2 hours post Tx.
24 hrs
7-10 days
3 months

42 max

Question 15

NIH Score Severity for

0
1-4
5-15
16-20
21-42

Answer 15

No stroke Symptoms
Minor
Moderate
Mod to severe
Severe

Question 16

80% of CVAs are

Answer 16

Ischemic

Question 17

Decrease Blood flow from Ischemic attacks caused by

Answer 17

Thrombus

Embolic

Question 18

An occlusion of small vessels associated with HTN or diabetes

Answer 18

Lacunar Infarct

Question 19

excessive production of neurotransmitters

Answer 19

Ischemic tissue death

Question 20

Toxic levels of lactic acide and hydrogen ions

Answer 20

Anaerobic Metabolism

Question 21

Rim of mild to moderate Ischemic tissue around area of infarction

Answer 21

Penumbra

Question 22

Brain tissue requires ____ of regular Blood flow to survive

Answer 22

20-25%

Question 23

Common meds prescribed

Answer 23

Antiplatelets
Anticoagulants
Statins
Antihypertensives
Diabetic meds

Question 24

Sudden onset stroke
Linked to HTN
Causes decreased level of consciousness, headache, nausea, vomit

Answer 24

Hemorrhagic Stroke

Question 25

Hemorrhagic stroke includes

Answer 25

Intracerebral hemorrhage Subarachnoid hemorrhage Subdural hematoma Epidural hematoma

Question 26

Arterial bleeding into brain parenchyma

Answer 26

Intracerebral hemorrhage

Question 27

Etiology of Intracerebral Hemorrhage

Answer 27

Atherosclerosis Increase in BP >65 y/o

Question 28

Blood in subarachnoid space

Answer 28

Subarachnoid hemorrhage

Question 29

40% of subarachnoid hemorrhage present with 60% with

Answer 29

Sentinel Headache Nausea,vomit,coma

Question 30

Causes of Sub arachnoid hemorrhage

Answer 30

``` Atriovenous Malformation Age Trauma Neoplasm Inf HTN ```

Question 31

Most common AVM in subarachnoid hemorrhage Where does it occur?

Answer 31

Berry Aneurysm Biforcations (Circle of Willis)

Question 32

Trauma causing tear in bridging veins between brain surface and dural sinus

Answer 32

Subdural Hematoma

Question 33

What happens when subdural hematoma is small? Large?

Answer 33

Small:Absorbed by body Large: Requires evacuation

Question 34

Traumatic tearing of Meningeal arteries that supply periosteal layer of dura

Answer 34

Epidural Hematoma

Question 35

Epidural hematoma is a medical emergency that

Answer 35

Requires evacuation

Question 36

Difficulties speaking and interpreting speech

Answer 36

Aphasia

Question 37

3 types of aphasia and function loss

Answer 37

Brocas: expressive speech Wernickes: Receptive Speech Global: Mixed

Question 38

Impairment in reading

Answer 38

Alexia

Question 39

Impairment in writing

Answer 39

Agraphia

Question 40

Inability to execute voluntary Motor movement

Answer 40

Apraxia

Question 41

Loss of ability to perceive auditory, visual, and tactile input

Answer 41

Agnosia

Question 42

Lack of awareness of illness

Answer 42

Anosognosia

Question 43

Motor speech disorder affective respiration articulation and phonation

Answer 43

Dysarthria

Question 44

Difficulty swallowing

Answer 44

Dysphagia

Question 45

Unable to refrain from certain behaviors

Answer 45

Perseveration

Question 46

Know your flexion and extension synergies

Answer 46

Facts.

Question 47

What is most common region of CVA? And common cause

Answer 47

MCA (51%) Internal carotid Thrombus

Question 48

2 divisions of MCA

Answer 48

Superior (hemiparesis/Brocas Aphasias) Inferior (Homonymous hemianopsia/ wernickes aphasia)

Question 49

Responsible for learned behavior, voluntary initiation, planning

Answer 49

Right hemisphere

Question 50

Responsible for leaning and using language symbols

Answer 50

Left hemisphere

Question 51

Pusher syndrome midline

Answer 51

Ipsilesional

Question 52

Pusher syndrome presents with

Answer 52

Spontaneous posture to side of involvement | Resistance to passive correction of posture

Question 53

Pusher syndrom treatment involves

Answer 53

Visual Somatosensory And motor learning

Question 54

PCA CVA results in

Answer 54

Thalamic syndrome Homonymous hemianopsia Ataxia

Question 55

Damage to cerebellar arties result in

Answer 55

Ataxia Dysmetria Nausea Vertigo

Question 56

Vertebral artery syndromes

Answer 56

Wallenberg Horners

Question 57

Dysphagia Vertigo Nystagmus Impaired sensation on ipsi face and contra limbs

Answer 57

Wallenberg syndrome

Question 58

Ptosis of eyelid Constriction of pupil Lost of pain and temp contralateral

Answer 58

Horners syndrome

Question 59

results in mute, mortality, tetraplegia, and spared cognition

Answer 59

Basilar artery syndrome