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22 Cards in this Set

  • Front
  • Back
[TEST] What is the most common type of stroke?
Ischemic - 90% (vs. hemmorhagic)
[TEST] Small vessel disease is most often attributed to ____?
HTN
What is a lacunar stroke?
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.
What are the four types of ischemic strokes?
embolic occlusion
small vessel (due to HTN)
large vessel (due to cholesterol)
unknown cause
What is the single most important modifiable risk factor for stroke?
HTN
What are the two primary types of hemorrhagic stroke?
1. Lobar -75% (lobes, diffuse)

2. Subarachnoid - 25%
[TEST] What is the most common area that is damaged/bleed in lobar hemorrhagic stokes due to HTN?
putamen (lacunar stroke)
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)
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)
* What are the symptoms of a left MCA stroke?
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
* What are the symptoms of a right MCA stroke?
*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
What remains intact in a Broca's aphasia? Wernicke's?
Broca: comprehension and reading OK, output/expression knocked out

Wernicke's: Verbal expression OK, but all comprehension knocked out
Would you typically see aphasia or neglect in a lacunar stroke? other symptoms?
No. recall - lacunar is closer to brainstem not cortex ... typically contralateral one sided weakness ... often CN affected 3, 6 or 7
What is the visual defect in a IIIrd nerve palsy?
Inability to converge gaze

Note: Internuclear ophthalmoplegia (INO) can converge gaze, but disorder in lateral gaze, defect to MLF; often from demyelination of MS
[TEST] what is preserved in a spinal cord infarction?
position and vibration
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
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
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®)
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
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
what is tPA, when should it be dosed?
Tissue Plasminogen Activator (anti-clotting)

within 4.5 hours (sooner the better)
** What is the ABCDE stroke treatment?
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