Stroke

Question 1

A Rosier score of below 0 indicates what?

Answer 1

Stroke is likely

Question 2

A Rosier score of above 0 indicates what?

Answer 2

Low likely hood of stroke

Question 3

What imaging technique is used in the acute phase of stroke treatment?

Answer 3

CT

Question 4

What imaging technique is used in the chronic phase of stroke treatment?

Answer 4

MRI

Question 5

85% of strokes are due to….

Answer 5

Infarcts

Question 6

What are some of the main causes of infarcts?

Answer 6

Atheroemboli
Small Vessel
Cardioembolic
Malignancy

Question 7

10% of strokes are due to….

Answer 7

Haemorrhagic

Question 8

What are some of the common causes of haemorrhagic strokes?

Answer 8

Amyloid antipathy
Hypertension
Structural abnormality

Question 9

5% of strokes are due to….

Answer 9

Sub arachnoid haemorrhage

Question 10

FAST

Answer 10

Face
Arms
Speech
Time

Question 11

When can thrombolysis be used?

Answer 11

<4.5 hours since onset of symptoms

Question 12

What is the drug of choice used in thrombolysis?

Answer 12

tPA

Question 13

What other rescue therapy is available?

Answer 13

Endovascular therpay

CT angiogram guided catheterisation

Question 14

In a mild stroke what drugs are used?

Answer 14

Aspirin 300mg

Clopidogrel

Question 15

Before administering anti platelets what should you know?

Answer 15

You need to wait 24 hours post thrombolysis and a CT to know if there is a bleed or not.

Question 16

DVT prophylaxis

Answer 16

Intermittent pneumatic compression reduces risk.

Drugs such as heparin needs to be carefully weighed against the risk of bleeding.

Question 17

TIA

Answer 17

Transient Ischaemic Attack

Brief episode of neurological symptoms

Question 18

Why are TIAs not considered benign?

Answer 18

Dramatically increased risk of stroke after a TIA

Question 19

A total Anterior circulation stroke presents with what?

Middle and Anterior cerebral arteries affected.

Answer 19

Higher cerebral dysfunction
Homonymous visual field defects
Contralateral motor and sensory deficit

Question 20

A posterior stroke presents with what?

Answer 20

Cerebellar dysfunction - DANISH
Isolated homonymous field defects
Cranial nerve dysfunction - brainstem involvement

Question 21

What is a lacunar stroke?

Answer 21

Purely motor or sensory

Question 22

What is DANISH - Posterior stroke

Answer 22

Dysdiadochokinesia 
Ataxia
Nystagmus
Intention tremor
Slurred staccato speech
Hypotonia

Question 23

What is dysdiachokinesia?

Answer 23

Difficulty in performing fast alternating movements e.g
Use door handle
Tap foot rapidly

Question 24

What are some higher cerebral dysfunctions?

Answer 24

Brocas (Expressive) dysphasia

Wernickes (Receptive) dysphasia

Question 25

What is expressive aphasia?

Answer 25

Brocas | Difficulty producing coherent speech

Question 26

What is Wernickes (Receptive) aphasia?

Answer 26

Hard to understand speech or written word.

Question 27

If someone has Broca's (expressive) dysphasia which region of the brain is likely to be damaged?

Answer 27

Inferior frontal gyrus

Question 28

If someone has receptive aphasia which region of the brain is likely to be damaged?

Answer 28

Superior temporal gyrus | Wernickes Aphasia