Spmp Acute Ischemic Stroke

Front 1

SPMP 01

A 55 year-old man is admitted with H/O sudden onset weakness of right upper and lower limbs. The weakness was noticed in early morning hours. Here we are talking about:

Back 1

Acute Ischemic Stroke

Front 2

I. 01.
The patient was fully conscious but aphasic. Most likely diagnosis is:

A. CVA MCA territory stroke

B. Pontine hemorrhage

C. Vertibro-basilar stroke

D. Subarachnoid hemorrhage

E. Slow growing cerebral tumor

Back 2

A. CVA MCA territory stroke

Front 3

I. 02.
Detailed clinical examination of this patient is aimed at the following:

A. determining the neurological deficits

B. localising the level of lesion

C. assessing the degree of hypertension

D. detecting co morbid conditions

E. all of the above

Back 3

E. all of the above

Front 4

I. 03.
Important risk factors for A/c Ischemic stroke are the following EXCEPT:

A. Essential Hypertension

B. Diabetes Mellitus

C. Hyper-lipidemia

D. Alcohol in moderation

E. Hyper-homocystinemia

Back 4

D. Alcohol in moderation

Front 5

I. 04.
Differential diagnoses of A/c Ischemic stroke include the following EXCEPT:

A. Metabolic encephalopathy

B. Post ictal Todd’s paralysis

C. Prion Disease

D. Complicated migraine

E. Demyelinating disease

Back 5

C. Prion Disease

Front 6

I. 05.
Imaging investigations indicated in this patient are the following EXCEPT:

A. CT scan

B. MRI scan

C. Electromyography

D. Carotid ultrasound scan

E. Cerebral angiography

Back 6

C. Electromyography

Front 7

I. 06.
Emergency CT scan head is indicated for following reasons EXCEPT:

A. Fast

B. Inexpensive

C. Availability

D. No risk of radiation

E. Highly sensitive for ICH

Back 7

D. No risk of radiation

Front 8

I. 07.
Anti-edema measures in management are the following EXCEPT:

A. Mannitol 20% as IV infusion in 20 minutes

B. Oral glyzerine 30ml three times daily

C. Acetazolamide 250 mg TID

D. Frusemide 200mg IV 8 hrly

E. Dexamethasone 4mg 8hrly IV

Back 8

D. Frusemide 200mg IV 8 hrly

Front 9

I. 08.
Following about management of BP in acute stroke are TRUE EXCEPT:

A. Generally hypertension is not be treated

B. BP >200/115 should be treated

C. The drug of choice is short acting ones

D. Hypotension detrimental than hypertension

E. Hypotension should not be treated at all

Back 9

E. Hypotension should not be treated at all

Front 10

I. 09.
Attention is needed to the following EXCEPT:

A. Ensuring adequate dehydration

B. Adding additional nutrional supplements

C. Ryle’s tube feeding if unable to swallow

D. Maintaining euglyzemia

E. Providing a pressure relieving mattress

Back 10

A. Ensuring adequate dehydration

Front 11

I. 10.
IV rTPA is beneficial if given within 1st 3hours for following reasons, EXCEPT:

A. Decreases the chance of neurlogical disability

B. Trend towards reduced mortality

C. Earlier it is given, greater the benefit

D. Risk of ICH increase with infarct’s age and size

E. It is very cheap and routinely available

Back 11

E. It is very cheap and routinely available

Front 12

I. 11.
Additional contra-indications for rTPA include the following EXCEPT:

A. ICH, stroke or trauma in preceding 3 months

B. Hemorrhagic Embolic stroke

C. Recent surgery or bleeding

D. Thrombocytosis

E. Coagulopathy

Back 12

D. Thrombocytosis

Front 13

I. 12.
Following statements about anti-coagulation in stroke are TRUE, EXCEPT:

A. Heparin is not indicated routinely

B. Warfarin is started if AF is present

C. Another indication is prosthetic heart valve

D. The target INR while giving Warfarin is 4-5

E. Intracranial hemorrhage must be excluded

Back 13

D. The target INR while giving Warfarin is 4-5

Front 14

I. 13.
Important complications expected in stroke include the following EXCEPT:

A. Urinary tract infection

B. Acute diarrheal disease

C. Chest infection

D. Pressure sores

E. Deep vein thrombosis

Back 14

B. Acute diarrheal disease

Front 15

I. 14.
Measures adopted to reduce these complications r the following EXCEPT:

A. Tab Codiene phosphate TID

B. Avoiding aspiration

C. Avoiding catheterization

D. Frequent turning in bed and avoiding wetting

E. Anti-embolism stocking and passive stretching

Back 15

A. Tab Codiene phosphate TID

Front 16

I. 15.
Additional management in A/c ischemic stroke includes the following EXCEPT:

A. Passive physiotherapy

B. Active physiotherapy

C. Speech therapy

D. Complete Bed Rest

E. Prophylactic antibiotics

Back 16

D. Complete Bed Rest

Front 17

I. 16.
Strategies for secondary prevention include the following, EXCEPT:

A. Keeping the blood pressure above 160/100

B. Identifying and treating cardiac embolic source

C. Endarterectomy for Carotid Artery Thrombus

D. Vertebral artery dissection – surgery

E. Statins in treating hyper-lipidemia

Back 17

A. Keeping the blood pressure above 160/100

Front 18

I. 17.
Antiplatelet drugs in secondary prevention include the following EXCEPT:

A. Aspirin 50-325mg daily orally

B. Clopidogrel 75mg daily

C. Sibuteramine 10mg TID

D. Dipyridamole 100mg daily

E. Ticlopidine 250mg BID

Back 18

C. Sibuteramine 10mg TID