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Neuro 5 TIA/Stroke Test

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1.
What are the 5 main lacunar syndromes that may arise from lunar infarct?
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2.
What neuro defects would be seen with an infarct of the following aa?: anterior cerebral a
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3.
List 4 major sx of a TIA.
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4.
What are the lipid parameters indicated for tx of carotid a stenosis?
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5.
What is the anticoag of choice in a pt with first TIA?
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6.
A lesion to which area of the brain is responsible for the following clinical scenario?: agraphia and acalculia
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7.
What is the MC a involved in embolic ischemic stroke?
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8.
A lesion to which area of the brain is responsible for the following clinical scenario?: hemispatial neglect syndrome
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9.
Meningitis is dx in a neonate. What are the most likely organisms, and what is the empiric tx?
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10.
What should always be done prior to an LP?
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11.
A lesion to which area of the brain is responsible for the following clinical scenario?: coma
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12.
What is the difference in starting antiplatelet medications in the case of an ischemic vs a hemorrhagic stroke?
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13.
What is the principle cause of a lacunar infarct?
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14.
What neuro defects would be seen with an infarct of the following aa?: basilar a
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15.
Should you use ezetimibe to treat dyslipidemia in a pt with TIA/stroke? Why or why not?
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16.
What neuro defects would be seen with an infarct of the following aa?: middle cerebral a
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17.
In what timeframe must thrombolytic therapy be instituted in cases of ischemic stroke?
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18.
What is the anticoag of choice in a pt with repeat TIA/stroke while on aspirin
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19.
What neuro defects would be seen with an infarct of the following aa?: posterior cerebral a
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20.
A pt with DVT develops a stroke. What study would most likely ID the underlying etiology of the stroke?
A.
Contralateral loss of sensory and motor info to the legs, feet, and trunk
B.
GBS, E coli, Listeria. Tx: amp and gent
C.
1. Amarosis fugax 2. Weakness 3. Slurred speech 4. Impaired coordination
D.
Aphasia and loss of sensory and motor to the face, arms, and hands
E.
TEE
F.
Clopidogrel or Aggrenox (ASA + dipyridamole)
G.
HTN
H.
Ischemic: start within 48h Hemorrhagic: wait for 2 weeks (and pt stability)
I.
<3h from onset for systemic thrombolytics. <6h for local thrombolytics with a specialist on site.
J.
1. Pure motor hemiparesis (MCC) 2. Pure sensory 3. Ataxic hemiparesis 4. Sensorimotor stroke 5. Dysarthria-clumsy hand syndrome
K.
Neuro exam (look for evidence of increased ICP like papilladema)
L.
Dominant parietal lobe (usually L)
M.
Reticular activating system
N.
No b/c it can increase plaque thickness. Naughty.
O.
LDL <100, HDL >35, triglyc <200. Accomplish with statins
P.
MCA
Q.
visual defects (unilateral hemianopia with macular sparing)
R.
1. CN abnormalities 2. Contralateral full body weakness 3. Coma/alteration of consciousness
S.
ASA
T.
Non-dominant parietal lobe (usually R)
Type the Answer that corresponds to the displayed Question.
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21.
What is the anticoag of choice in a pt with TIA/stroke due to a fib?
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22.
How long must a focal neuro deficit last to qualify as a stroke?
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23.
What is the threshold for BP in order to treat a TIA/stroke with thrombolytics?
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24.
What is the general "blanket rule" for surgical indications for carotid endarterectomy?
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25.
What level of HTN control is indicated for tx of carotid a stenosis?
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26.
What neuro defects would be seen with an infarct of the following aa?: lacunar aa
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27.
A lesion to which area of the brain is responsible for the following clinical scenario?: personality changes
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28.
What is the anticoag of choice in a pt with TIA/stroke and CAD?
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29.
What dyslipidemia drug reduces cartotid a intima thickness?
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30.
You should not treat HTN immediately following a stroke unless it is a what level?

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