TIA and Stroke
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| A lesion to which area of the brain is responsible for the following clinical scenario?: agraphia and acalculia | Dominant parietal lobe (usually L)
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| A lesion to which area of the brain is responsible for the following clinical scenario?: hemispatial neglect syndrome | Non-dominant parietal lobe (usually R)
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| A lesion to which area of the brain is responsible for the following clinical scenario?: personality changes | Frontal lobe
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| A lesion to which area of the brain is responsible for the following clinical scenario?: coma | Reticular activating system
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| 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
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| What should always be done prior to an LP? | Neuro exam (look for evidence of increased ICP like papilladema)
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| What is the anticoag of choice in a pt with first TIA? | ASA
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| What is the anticoag of choice in a pt with TIA/stroke due to a fib? | Warfarin
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| What is the anticoag of choice in a pt with TIA/stroke and CAD? | Clopidogrel (Plavix)
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| What is the anticoag of choice in a pt with repeat TIA/stroke while on aspirin | Clopidogrel or Aggrenox (ASA + dipyridamole)
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| What is the general "blanket rule" for surgical indications for carotid endarterectomy? | >60% and asymptomatic
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| What level of HTN control is indicated for tx of carotid a stenosis? | <140/90
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| What are the lipid parameters indicated for tx of carotid a stenosis? | LDL <100, HDL >35, triglyc <200. Accomplish with statins
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| What dyslipidemia drug reduces cartotid a intima thickness? | Niacin
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| List 4 major sx of a TIA. | 1. Amarosis fugax
2. Weakness
3. Slurred speech
4. Impaired coordination
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| 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
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| How long must a focal neuro deficit last to qualify as a stroke? | >24h
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| 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.
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| What is the principle cause of a lacunar infarct? | HTN
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| A pt with DVT develops a stroke. What study would most likely ID the underlying etiology of the stroke? | TEE
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| 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
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| 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
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| What neuro defects would be seen with an infarct of the following aa?: posterior cerebral a | visual defects (unilateral hemianopia with macular sparing)
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| What neuro defects would be seen with an infarct of the following aa?: lacunar aa | Lacunar syndrome
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| 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
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| 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.
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| What is the threshold for BP in order to treat a TIA/stroke with thrombolytics? | <185/110
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| You should not treat HTN immediately following a stroke unless it is a what level? | >220/120.
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| What is the MC a involved in embolic ischemic stroke? | MCA
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| 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)
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Created by:
sarah3148
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