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Neuro 5 TIA/Stroke

TIA and Stroke

QuestionAnswer
A lesion to which area of the brain is responsible for the following clinical scenario?: agraphia and acalculia Dominant parietal lobe (usually L)
A lesion to which area of the brain is responsible for the following clinical scenario?: hemispatial neglect syndrome Non-dominant parietal lobe (usually R)
A lesion to which area of the brain is responsible for the following clinical scenario?: personality changes Frontal lobe
A lesion to which area of the brain is responsible for the following clinical scenario?: coma Reticular activating system
Meningitis is dx in a neonate. What are the most likely organisms, and what is the empiric tx? GBS, E coli, Listeria. Tx: amp and gent
What should always be done prior to an LP? Neuro exam (look for evidence of increased ICP like papilladema)
What is the anticoag of choice in a pt with first TIA? ASA
What is the anticoag of choice in a pt with TIA/stroke due to a fib? Warfarin
What is the anticoag of choice in a pt with TIA/stroke and CAD? Clopidogrel (Plavix)
What is the anticoag of choice in a pt with repeat TIA/stroke while on aspirin Clopidogrel or Aggrenox (ASA + dipyridamole)
What is the general "blanket rule" for surgical indications for carotid endarterectomy? >60% and asymptomatic
What level of HTN control is indicated for tx of carotid a stenosis? <140/90
What are the lipid parameters indicated for tx of carotid a stenosis? LDL <100, HDL >35, triglyc <200. Accomplish with statins
What dyslipidemia drug reduces cartotid a intima thickness? Niacin
List 4 major sx of a TIA. 1. Amarosis fugax 2. Weakness 3. Slurred speech 4. Impaired coordination
What are the 5 main lacunar syndromes that may arise from lunar infarct? 1. Pure motor hemiparesis (MCC) 2. Pure sensory 3. Ataxic hemiparesis 4. Sensorimotor stroke 5. Dysarthria-clumsy hand syndrome
How long must a focal neuro deficit last to qualify as a stroke? >24h
In what timeframe must thrombolytic therapy be instituted in cases of ischemic stroke? <3h from onset for systemic thrombolytics. <6h for local thrombolytics with a specialist on site.
What is the principle cause of a lacunar infarct? HTN
A pt with DVT develops a stroke. What study would most likely ID the underlying etiology of the stroke? TEE
What neuro defects would be seen with an infarct of the following aa?: anterior cerebral a Contralateral loss of sensory and motor info to the legs, feet, and trunk
What neuro defects would be seen with an infarct of the following aa?: middle cerebral a Aphasia and loss of sensory and motor to the face, arms, and hands
What neuro defects would be seen with an infarct of the following aa?: posterior cerebral a visual defects (unilateral hemianopia with macular sparing)
What neuro defects would be seen with an infarct of the following aa?: lacunar aa Lacunar syndrome
What neuro defects would be seen with an infarct of the following aa?: basilar a 1. CN abnormalities 2. Contralateral full body weakness 3. Coma/alteration of consciousness
Should you use ezetimibe to treat dyslipidemia in a pt with TIA/stroke? Why or why not? No b/c it can increase plaque thickness. Naughty.
What is the threshold for BP in order to treat a TIA/stroke with thrombolytics? <185/110
You should not treat HTN immediately following a stroke unless it is a what level? >220/120.
What is the MC a involved in embolic ischemic stroke? MCA
What is the difference in starting antiplatelet medications in the case of an ischemic vs a hemorrhagic stroke? Ischemic: start within 48h Hemorrhagic: wait for 2 weeks (and pt stability)
Created by: sarah3148