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22 Cards in this Set
- Front
- Back
[TEST] What is the most common type of stroke?
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Ischemic - 90% (vs. hemmorhagic)
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[TEST] Small vessel disease is most often attributed to ____?
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HTN
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What is a lacunar stroke?
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Lacunes are caused by occlusion of a single deep penetrating artery that arises directly from the constituents of the Circle of Willis, cerebellar arteries, and basilar artery.
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What are the four types of ischemic strokes?
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embolic occlusion
small vessel (due to HTN) large vessel (due to cholesterol) unknown cause |
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What is the single most important modifiable risk factor for stroke?
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HTN
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What are the two primary types of hemorrhagic stroke?
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1. Lobar -75% (lobes, diffuse)
2. Subarachnoid - 25% |
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[TEST] What is the most common area that is damaged/bleed in lobar hemorrhagic stokes due to HTN?
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putamen (lacunar stroke)
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A left middle cerebral artery (MCA) stroke is typically associated with all of the following except:
A. Aphasia B. Gaze deviation to the right C. Right side weakness D. Right hemianopia |
B. Gaze deviation to the right (gaze TOWARD the lesion in stroke, AWAY from lesion in seizure)
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A left lacunar stroke is typically associated with all of the following except:
A. Aphasia B. Right hemiparesis C. Right hemianesthesia D. Right hemiataxia |
A. Aphasia (tends to be associated with cortical stroke)
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* What are the symptoms of a left MCA stroke?
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Aphasia
Right hemiparesis (weakness) - Face and arm more than leg Right hemianesthesia (sensory loss) Right hemianopia (visual loss on the right out of each eye) Deviation of eyes to left |
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* What are the symptoms of a right MCA stroke?
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*Neglect
Left hemiparesis (weakness) - Face and arm more than leg Left hemianesthesia (sensory loss) Left hemianopia (visual loss on the left out of each eye) Deviation of eyes to right |
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What remains intact in a Broca's aphasia? Wernicke's?
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Broca: comprehension and reading OK, output/expression knocked out
Wernicke's: Verbal expression OK, but all comprehension knocked out |
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Would you typically see aphasia or neglect in a lacunar stroke? other symptoms?
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No. recall - lacunar is closer to brainstem not cortex ... typically contralateral one sided weakness ... often CN affected 3, 6 or 7
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What is the visual defect in a IIIrd nerve palsy?
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Inability to converge gaze
Note: Internuclear ophthalmoplegia (INO) can converge gaze, but disorder in lateral gaze, defect to MLF; often from demyelination of MS |
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[TEST] what is preserved in a spinal cord infarction?
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position and vibration
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A left middle cerebral artery (MCA) stroke is typically associated with all of the following except:
A. Aphasia B. Gaze deviation to the right C. Right side weakness D. Right hemianopia |
B. Gaze deviation to the right
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A left lacunar stroke is typically associated with all of the following except:
A. Aphasia B. Right hemiparesis C. Right hemianesthesia D. Right hemiataxia |
A. Aphasia
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In a patient with atrial fibrillation and stroke, the treatment of choice for secondary stroke prevention is:
A. Aspirin B. Clopidogrel (Plavix®) C. Aspirin/Dipyridamole combination (Aggrenox®) D. Warfarin (Coumadin®) |
D. Warfarin (Coumadin®)
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A patient with a left MCA stroke had 75% stenosis of the left internal carotid artery. Of the following, the best treatment to prevent a stroke over the next 2 years is:
A. Aspirin B. Clopidogrel (Plavix®) C. Carotid endarterectomy D. Smoking cessation |
C. Carotid endarterectomy
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Which of the following is not recommended long-term after stroke?
A. Aspirin B. Blood pressure lowering C. Exercise D. None of the above |
D. None of the above
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what is tPA, when should it be dosed?
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Tissue Plasminogen Activator (anti-clotting)
within 4.5 hours (sooner the better) |
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** What is the ABCDE stroke treatment?
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A(2)BC(3)D(2)E
Antiplatelet (aspirin, plavix: best choice for non a-fib), Anticoagulant (warfarin: best choice if a-fib) BP Control Carotid artery repair Cholesterol lowering Cessation of smoking Diet Exercise D |