Stroke

Question 1

Stroke is the leading cause of ________________.

Answer 1

Long-term disability

Question 2

85% of strokes are _____________.

Answer 2

Ischemic

Question 3

A transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia without acute infarction is known as a(n) ______________________.

Answer 3

Transient Ischemic Attack (TIA)

Question 4

During a stroke, 2 million __________ die each minute without blood flow or oxygen.

Answer 4

Neurons

Question 5

During a stroke, 14 million __________ die each minute without blood flow or oxygen.

Answer 5

Synapses

Question 6

What are common risk factors for stroke?

Answer 6

• Age
• Gender
• Hypertension (HTN)
• Diabetes (DM)
• Dyslipidemia
• Smoking

Question 7

What is the primary standard of care for a patient undergoing a stroke?

Answer 7

Administration of tPA Stroke care in a specialized stroke unit

Question 8

The three things to avoid when treating a stroke patient are:

Answer 8

• Avoid treating hypertension.
  
  • The stroke has caused the body’s acute rise in BP.
  • The BP will decrease on its own within a few days.
  • Lowering the BP will damage the penumbra of the stroke patient.
• Avoid giving glucose.
  
  • High glucose damages the penumbra and worsens the outcome
  • Only give glucose if the patient is severely hypoglycemic (<50 mg/dL)
• Avoid causing aspiration pneumonia.
  
  • Weak oropharyngeal muscles are common in stroke patients.
  • Do elevate the head of the patient’s bed to 30°, keep medications NPO (not by mouth), and rotate patient for emesis (vomiting)

Question 9

When material from the heart travels distally to form a clot in the neck or cranium, it is referred to as a(n) _________________.

Answer 9

Cardio embolism

Question 10

An occlusion or embolism of a large vein or artery in the head or neck is referred to as __________________.

Answer 10

Large vessel disease

Question 11

An occlusion of a smaller vein or artery in the head or neck, particularly the perforating arteries of the cerebrum, is referred to as ________________.

Answer 11

Small vessel disease

Question 12

Some of the leading causes for cardio embolism are:

Answer 12

• Atrial fibrillation
• Atrial myxoma (tumor of the cardiac muscle)
• Endocarditis
• Valvular calcification

Question 13

When diagnosing a stroke, what tests should be performed concerning brain tissue?

Answer 13

• CT
• MRI

Question 14

When diagnosing a stroke, what tests should be performed concerning the blood?

Answer 14

• Hypercoaguability panel
• Platelet function assay (PFA)

Question 15

When diagnosing a stroke, what tests should be performed concerning the cerebrospinal fluid?

Answer 15

Lumbar puncture (LP)

Question 16

No tissue plasminogen activator (tPA) may be given to a patient if ____________ or ____________ is detected on a brain CT.

Answer 16

• Hemorrhage
• Subacute ischemia
  
  • Lesion will appear dark on CT scan if it is subacute, suggesting the condition is more than 3 hours old.

Question 17

If you suspect a patient of having a subarachnoid hemorrhage, but fail to detect it on a CT exam, what subsequent test should you perform?

Answer 17

Lumbar puncture (LP)

Question 18

What is shown on the following CT scan? What would the treatment option be?

Answer 18

• Intracerebral hemorrhage
• Do not administer tPA in this case.

Question 19

What is shown on the following CT scan? What would the treatment option be?

Answer 19

• Subacute ischemia. The condition is more than 3 hours old.
• Do not administer tPA in this case.

Question 20

What is shown on the following CT scan?

Answer 20

MCA subacute ischemia.

Question 21

What is shown on the following CT scan?

Answer 21

PCA subacute ischemia.

Question 22

What is shown on the following CT scan?

Answer 22

ACA subacute ischemia.