Stroke

Question 1

ABCD2 Score risk score

Answer 1

Max score is 7
2 day risk of stroke

A- age 60+ (1)
B- blood pressure over 140/90 (1)
C- clinical symptoms: focal weakness (2) or speech impairment with no weakness (1)
D-duration: more than 60 mins (2), 10-59 mins (1)
D- Diabetes (1)

Question 2

What type of imaging should someone have if they had suspected stroke?

Answer 2

MRI

Question 3

What is the critical time to reperfuse the penumbra?

Answer 3

2-4 hours

Question 4

What is the window for using tPA?

Answer 4

3-4.5 hours

Question 5

Name 7 contraindications for tPA

Answer 5

-patient must be over 18

1. Stroke or head trauma in the past 3 months
2. Persistent BP elevation (systolic must be below 185
3. Active internal bleeding
4. Serum glucose <50
5. Heparin use in the last 48 hrs.
6. Severe stroke, NIHSS score >25
7. > 80 years

Question 6

What are the 3 components of the Cincinnati Pre-Hospital Stroke Scale

Answer 6

1. Smile
2. Pronator drift
3. “Can’t teach an old dog new tricks”

Question 7

What is the most important predictor of an ischemic problem becoming hemorrhagic?

Answer 7

size of the infarction

Question 8

What medication is prudent to give pt following subarachnoid hemorrhage?

Answer 8

CCB to treat vasospasm (ex. Nicardipine, Nimedipine)

Question 9

What would you find in CSF of a subarrachnoid hemorrhage?

Answer 9

xanthochromia = hemolyzed bood in the CSF

Question 10

What are the 3 first tier recommendations for managing a stroke (CVA) patient?

Answer 10

1. Labs: CBC, CMP, glucose, PT/PTT
2. EKG
3. CT without contrast