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36 Cards in this Set
- Front
- Back
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what is contributing to the decrease in stroke prevalence?
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decreasing rate of smoking & increased control of hypertension
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what are the two common origins for emboli in TIAs?
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cardiac or carotid
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which is more susceptible to infarction from ischaemia: white or grey matter? Why?
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White matter. It is less vascularized, & has fewer anastomoses to protect it.
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why is subarachnoid haemorrhage a differential diagnosis for a patient with neck stiffness & photophobia?
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blood acts as a chemical irritant, causing 'meningism' in SAH
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a 70 year old patient presents well, but says yesterday family members complained she seemed unable to remember anything & confused what they were doing for several hours. What is the likely syndrome? Are they at risk of stroke?
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Transient Global Amnesia (TGA), which is not a risk factor for stroke. Rather, it is due to basilar artery spasm, causing impairment of mesial temporal lobes and hippocampi.
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in a young patient who is presenting post-stroke, what additional investigations should be considered?
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Those investigating thrombophilias: a) antiphospholipid syndrome, b) Factor V Leiden, c) Protein C & S deficiencies
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what is the gold standard investigating arterial anatomy?
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Selective angiography
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what imaging should be performed in a patient, after a TIA?
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carotid ultrasound
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what imaging modalities are used for investigating vasculature after a stroke?
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1) helical CT angiography, 2) MR angiography
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a patient describes a change of vision in one eye for 5 min, where they saw a shadow in their field of vision. What is this called? What is it associated with?
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This is Amaurosis Fugax, and associated with carotid atheromas
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what presentations of TIA should be considered a medical emergency?
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a) transient hemiparesis, b) quadraparesis + blindness, c) transiet aphasia
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What is Gerstmann syndrome? What cerebral artery is it associated with?
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Agraphia, Acalculia, R/L confusion, Finger agnosia. Associated with the MCA, when the dominant parietal lobe is affected
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you suspect a patient has had a stroke, and they are having difficulty looking to one side. What artery do you suspect?
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MCA
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hemiparesis & sensory disturbance with homonymous hemianopia is characteristic of occlusion of which artery?
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MCA
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Contralateral neglect typically occurs with what type of stroke?
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MCA (in non-dominant hemisphere)
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a patient is brought in by their daughter, and they have a paralyzed, numb left leg. They sit quietly and let their daughter do the talking, but are able to answer your questions without slurring of speech. What artery was likely occluded?
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ACA (note the abulia)
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What is Anton's syndrome, and what type of stroke is it associated with?
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Unawareness of one's visual deficits, due to macular sparing. Associated with PCA strokes.
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A patient presents with an obvious Horner's syndrome, complaining they are having problems swallowing and feeling temperature on the opposite side of the body. You suspect what type of stroke?
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Lateral Medullary Syndrome (PICA involvement)
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what is the greatest known risk factor for lacunar infarcts?
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Hypertension.
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How do Bell's Palsy and Ramsay Hunt differ? How are they treated?
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Ramsay Hunt is caused by VZV. It should be treated with corticosteroids and acyclovir.
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What is the most common cause of peripheral neuropathy?
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Idiopathic
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What are the signs of an UMN lesion?
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Increased reflexes, Clonus, Muscle wasting
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What is the triad found in Miller-Fischer Syndrome?
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ataxia areflexia ophthalmoplegia
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What are signs of a common fibular nerve palsy?
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Weakness on foot dorsiflexion and eversion, Sensory loss in dosrum of foot?
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What is the main reason for doing urodynamic tests in bladder dysfunction?
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To check for renal damage
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What is the most common cause of spinal injury?
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Non traumatic cause: infection, invasion etc
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Which nerve controls the external sphincter?
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pudendal nerve
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Does the sympathetic NS relax or contract the bladder?
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relax
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What is the name of the center controlling micturation?
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Pontine micturation center
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How often should you review patients with neurogenic bladder? How often do you US kidneys?
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Every year/every year first 3 years, then every 2 years.
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What is a typical initial symptom of Multiple Sclerosis?
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Optic neuritis
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What is needed for diagnosis of multiple sclerosis?
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Clinical history of 2 attacks or one attack plus MRI findings
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What is the treatment for multiple sclerosis?
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DMARDs plus steroid for acute attacks
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What is L'hermitte's sign?
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electric shock when flexing neck
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What is known about genetic factors in MS?
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Monozygotic Twin concordance rate of 30%
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What are the MacDonald criteria?
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A diagnostic algorithm for MS
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