Stroke

Question 1

what conditions can mimic a stroke?

Answer 1

seizure
sepsis
metabolic eg DKA
SOL
syncope
delirium

Question 2

outline the components of the rosier score

Answer 2

loss of consciousness/syncope
seizure activity
acute onset: weakness, disturbance in vision/speech

Question 3

when does a CT become ineffective at looking at blood and why?

Answer 3

1 week

blood reabsorbs so you cant see the white anymore

Question 4

best imaging for blood after a week?

Answer 4

MRI

Question 5

name the 4 different areas in which a stroke can occur?

Answer 5

posterior circulaion infarct
lacumar
total anterior circulation
partial anterior circulation

Question 6

what does TACS mean in terms of stroke

Answer 6

total anterior circulation syndrome

Question 7

how is a stroke named?

Answer 7

area it is PLUS whether it is a:
syndrome (s)
haemorrhage (h
infarct (i)

Question 8

TACS presents with…

Answer 8

hemiplegia involving 2 of face, arm, leg
homonymous hemianopia
cortical signs

Question 9

most severe type of stroke?

Answer 9

TACS

Question 10

where are lacunar infarcts?

Answer 10

deep parts of the brain eg basal ganglia, white matter, thalamus. brain stem

Question 11

what is a lacunar syndrome caused by

Answer 11

occlusion of a single deep penetrating artery

Question 12

lacunar syndrome will affect what parts of the body?

Answer 12

face arm leg

Question 13

what stroke has the best prognosis?

Answer 13

lacunar

Question 14

how does the presentation of PACS differ from TACS?

Answer 14

has only a few of the features of TACS
motor/sensory signs
isolated cortical dysfunction

Question 15

POCS wll present with…

Answer 15

cranial nerve palsyies
BILATERAL motor/sensory defects
homonymous hemianopia
blindness

Question 16

a __ sided stroke will give you more disability after

Answer 16

left

Question 17

what stroke type presents with bilateral motor and sensory signs

Answer 17

POCS

Question 18

LHS brain is responsible for what functions

Answer 18

reasoning
spoken and written language
number skills

Question 19

what side of the brain is responsible for creativity, music, spacial orientation and artistic awareness?

Answer 19

RHS

Question 20

most common cause of stroke

Answer 20

atheroembolism usually from carotid

Question 21

a thrombus finally lodges in the ___ to cause an ischaemic stroke

Answer 21

cerebral

Question 22

Ix of stroke

Answer 22

angiogram

doppler USS carotid

Question 23

what autoimmune conditions can cause strokes?

Answer 23

vasculitis eg GPA, eGPA due to small vessel damage

Question 24

if a stroke patient has no risk factors and has a stroke, what could be the cause?

Answer 24

hereditary cerebral amyloid angiography

patent foramen ovale

Question 25

what does small vessel disease look like on MRI?

Answer 25

looks smudgy

Question 26

most common cardioembolic cause of stroke?

Answer 26

AF

Question 27

patient with recent MI who gets a stroke could have what cardioembolic causes?

Answer 27

ventricular thrombus | stasis from scar tissue

Question 28

what congenital defect can cause stroke and why?

Answer 28

patent foramen ovale | blood moves from R to L overloading the arterial side thus forming clots

Question 29

Tx of arterial dissection

Answer 29

anticoagulation and antiplatelets

Question 30

what is a carotid arterial dissection?

Answer 30

tear in the innermost lining of the carotid artery

Question 31

primary intracerebral haemotthage is caused by...

Answer 31

hypertension | amyloid angiography

Question 32

a secondary intracerebral haemorrhage is caused by...

Answer 32

patent foramen ovale aneurysm tumour

Question 33

a lobar primary intracerebral haemorrhage suggests what cause?

Answer 33

cerebral amyloid angiopathy

Question 34

hypertension is more likely to cause a haemorrhage where?

Answer 34

deep in the brain

Question 35

acute Tx of stroke

Answer 35

``` thrombolysis/thrombectomy imaging swallow assessment nutrition/hydration antiplatelets DVT prophylaxis ```

Question 36

thrombolysis only works if given before __ hours

Answer 36

4.5

Question 37

what problems would make thrombolysis less effective?

Answer 37

``` diabetic patient hypertensive patient previous stroke time since stroke onset age ```

Question 38

outline the FAST mnemonic for stroke symptoms

Answer 38

facial weakness - can they smile? drooping? arm weakness- can they raise both arms? speech problems- can they speak and understand you? test all 3

Question 39

if blood is not present on the CT due to hyperacuteness, how else could you diagnose a stroke using imaging?

Answer 39

look for a hyper-dense middle cerebral artery

Question 40

how does thrombectomy work?

Answer 40

put a wire into the area of the clot and catch it using a stent, pull it out

Question 41

name the 3 main subtypes of stroke causes

Answer 41

cardioembolic atheroembolic small vessel disease

Question 42

Ix for stroke

Answer 42

``` lipid profile BP carotid scan ECG ECHO if cardioembolic ```

Question 43

ABCD of stroke prevention?

Answer 43

``` antithrombotics blood pressure cholesterol diabetes dont smoke ```

Question 44

main carotid surgery performed on stroke patients?

Answer 44

carotid endarterectomy