Stroke guidelines

Question 1

Stroke syndrome that involves contra lateral weakness of the leg > arm

Answer 1

Anterior cetebral artery syndrome

Question 2

Stroke syndrome that involves arm, face, upper and lower extremity more than the leg?

Answer 2

MCA syndrome

Question 3

In MCA stroke preferential gaze is to what side of the lesion?

Answer 3

Ipsilateral side

Question 4

Homonimous-hemianopsia with macular sparing is found in what stroke syndrome?

Answer 4

Part of MCA syndrome

Question 5

What division of the MCA is affected for expressive aphasia or Bocas aphasia?

Answer 5

MCA superior division

Question 6

Receptive aphasia is found in what division of MCA syndrome?

Answer 6

Inferior MCA

Question 7

In MCA syndrome global aphasia is noted when what side is affected?

Answer 7

Dominant side

Question 8

Agnosia, constructional apraxia, is present when the dominant part of the MCA territory is affected? True or false?

Answer 8

False. Non dominant side

Question 9

Px who cannot calculate, cannot Wright, cannot identify fingers, with left tor right confusion has what type of store syndrome?

Answer 9

Gertsman Syndrome

Affecting the dominant hemisphere of the MCA with partial occlusion

Question 10

Denial Blindness is seen in what stroke syndrome?

Answer 10

Antons Syndrome

Bilateral PCA stroke

Question 11

Contralteral weakness with ipsilateral CN 3 deficit

Answer 11

Webber syndrome of the PCA

Question 12

Contrlaeral rubral tremor (wing flapping) tremor

Answer 12

Claudes syndrome

Question 13

Ipsilateral cerebellar ataxia with contralteral weakness

Answer 13

Anterior Inferior cerebellar artery

Maeie-Foix syndrome

Question 14

Vical cord paralysis, dysphagia, dysarthria, hiccups

Answer 14

Posterior inferior cerebellar artery syndrome or wallendburg syndrome

Question 15

Locked in syndrome

Answer 15

Found in basilar artery syndrome

Question 16

Top 5 stoke mimics

Answer 16

Seizure
Infections
Tumor 
Toxicity
Positional vertigo

Question 17

Strongest risk factor for stroke among Filipinos

Answer 17

Hypertension

Question 18

Most prevalent risk factor for atherothrombosis

Answer 18

Smoking

Question 19

For primary stroke prevention regular screening shoud be done for hypertension at least every how many years?

Answer 19

Every 2 years

Question 20

Target A1c level for diabetic pxs with stroke

Answer 20

<7%

Question 21

To reduce stroke the target BP for pxs with DM shoud be?

Answer 21

<130/80

Question 22

For MI patients in order to prevent stroke oral anticoagulants are needed for the following risk factors

Answer 22

Persistent AF
Decreased EF
LV thrombosis detected

Question 23

Stroke pxs with LV mural thrombosis should have anticoagulants whatbisnthe target inr and duration?

Answer 23

InR 2-3

For at least 3 months to one year

Question 24

Pxs with rheumatic mitral valve disease or prosthetic heart valves need anticoagulants unless contraindicated

Answer 24

True

Question 25

When do you give aspirin in pxs with warfarin therapy?

Answer 25

For pxs with recurrence of embolism with or without AF

Question 26

For patients with AF who cannot take oral anticoagulants, what is the class 1a evidence drug alternative?

Answer 26

Aspirin at 325mg/ day

Question 27

For pxs with very high risk factors target ldl according to stroke guidelines is?

Answer 27

<70 mg/dl

Question 28

Mass screening for carotid artery stenosis is recommended? True or false

Answer 28

False Not cost effective

Question 29

CEA ( Carotid Endaraterectomy) is a class 1 indication for?

Answer 29

1. Symptomatic stenosis of >60%, life expectancy atleast 5 years, perioperative risk is <6% 2. TIA or stroke, ipsilateral carotid stenosis of 70-99%, perioperative risk <6% 3. Symptomatic patients with 50-69% carotid stenosis depending on px specific factors and initial symptoms

Question 30

For patients with ischemic stroke or TIA is screening for intracranial stenosis recommended?

Answer 30

Yes

Question 31

Medication used for prevention of progession of intracranial artery stenosis?

Answer 31

Aspirin + cilostazol

Question 32

What is the formula for Maximum hear rate?

Answer 32

220-age For secondary prevention of stroke 50-60% of maximal heart rate is beneficial

Question 33

Moderate intensity exercise is defined as?

Answer 33

Scale of 5 or 6 / 10 on relative scale 3.0-5.9 on absolute scale High in tensity is 6.0 or more on absolute scale And 7-8/10 on relative scale

Question 34

Recommended Peak oxygen uptake? Maximal heart rate? Heart rate reserve? For stroke survivors on aerobic exercises

Answer 34

Peak O2 and heart rate reserve - 40-70% Maximal heart rate 50-80%

Question 35

Recommended frequency and duration of aerobic exercises for stroke survivors?

Answer 35

3-7 days/ wk 20-60 minute duration

Question 36

Resistance training for stroke patients recommendation?

Answer 36

1-3 sets 10-15 reps 8-10 exercises involving large muscle groups

Question 37

BMI recommended for stroke prevention? Waist to Hip ration? Waist circumference?

Answer 37

18.5-24.9 BMI 1. 0 in men 0. 85 in women 35 inches in men 31 inches in women

Question 38

Recommended salt intake for stroke patients?

Answer 38

< 2.4 g/day Potassium 4.7 g/day

Question 39

Iosilateral CN6 palsy, with contralateral plegia

Answer 39

Raymond syndrome Pontine stroke paramedian branches

Question 40

CN 6 and 7 palsy with contralateral plegia

Answer 40

Millard-Gubler syndrome

Question 41

CN 12 palsy, contralteral plegia, loss of vibration sense, position sense pain

Answer 41

Dejerine Vertebral artery Medullary stroke type