strokes

Question 1

In VHL, whats more common, renal cell carcinoma or pheochromocytoma?

Answer 1

renal carcinoma is much more common.

Question 2

macrocytic anemia in alcoholic.

Answer 2

if it doesnt say megaloblastic, could just be a macrocytic anemia from the toxic damage alcohol has on the bone marrow.
-so dont disregard a thiamine deficiency just because you see alcoholic w/macrocytic anemia.

Question 3

Would you ever use lumbar puncture on a pt w/inc. ICP?

Answer 3

No, never.

-could lead to herniation.

Question 4

MCA stroke

-Sxs:

Answer 4

• language deficit or hemineglect.

- contra motor/sensory deficit in face/upper limbs.

Question 5

ACA stroke

-Sxs:

Answer 5

-contra motor/sensory deficit in lower limb.

Question 6

ASA stroke

-Sxs:

Answer 6

anterior spinal artery

• contra hemiparesis upper & lower limbs.
• dec. contra proprioception (DC/ML).
• Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).

Question 7

ASA stroke

-Sxs:

Answer 7

anterior spinal artery

• contra hemiparesis upper & lower limbs.
• dec. contra proprioception (DC/ML).
• ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).

Question 8

PICA stroke

-Sxs:

Answer 8

dec. pain and temperature sensation from ipsilateral face and contralateral body.

Question 9

PICA stroke

• what tissue is affected?
• Sxs:

Answer 9

• lateral medulla.

- dec. pain and temperature sensation from ipsilateral face and contralateral body.

Question 10

ASA stroke

-Sxs:

Answer 10

anterior spinal artery

• contra hemiparesis upper & lower limbs.
• dec. contra proprioception (DC/ML).
• ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).

*caudal medulla = hypoglossal n.

Question 11

PICA stroke

• what tissue is affected?
• Sxs:

Answer 11

• lateral medulla.
• dec. pain and temperature sensation from ipsilateral face and contralateral body.
• dysphagia, hoarseness.
• ipsi Horners.
• Vomiting, vertigo, nystagmus.

Question 12

Lateral medullary (Wallenberg) syndrome.

• wheres the stroke? which art & what region?
• Sxs:
• mnemonic:

Answer 12

• Nucleus ambiguus effects are specific to PICA lesions.
• “Don’t pick a (PICA) horse (hoarseness) that can’t eat
  (dysphagia) .”

Question 13

nucleus ambiguus

-function?

Answer 13

Motor innervation of pharynx, larynx, and upper esophagus (e.g., swallowing, palate elevation).
-its a vagal nuclei.

Question 14

Lateral medullary (Wallenberg) syndrome.

• wheres the stroke? which art & what region?
• Sxs:
• mnemonic:

Answer 14

• Nucleus ambiguus effects are specific to PICA lesions.
• “Don’t pick a (PICA) horse (hoarseness) that can’t eat
  (dysphagia) .”

Question 15

Which affects are specific to PICA lesion?

Answer 15

• Nucleus ambiguus effects are specific to PICA lesions.
• “Don’t pick a (PICA) horse (hoarseness) that can’t eat
  (dysphagia) .”

Question 16

Which affects are specific to PICA lesions?

Answer 16

• Nucleus ambiguus effects are specific to PICA lesions.
• “Don’t pick a (PICA) horse (hoarseness) that can’t eat
  (dysphagia) .”

Question 17

Which affects are specific to AICA lesions?

Answer 17

Facial nucleus effects are specific to AICA lesions.

“Facial droop means AICA’s pooped.”

Question 18

Which affects are specific to AICA lesions?

Answer 18

Facial nucleus effects are specific to AICA lesions.
“Facial droop means AICA’s pooped.”

*dont confuse w/loss of pain/temp from face like you can see in others. This is loss of motor function of facial nerve so you get dropping.

Question 19

PICA stroke

-what tissue is affected?

Answer 19

-lateral medulla.

Question 20

AICA stroke

-what tissue affected?

Answer 20

lateral pons.

Question 21

Basilar artery stroke

-Sxs:

Answer 21

“Locked-in syndrome.”

-pontine branches come from basilar art.

Question 22

Basilar artery stroke

-Sxs:

Answer 22

“Locked-in syndrome.”

• pontine branches come from basilar art.
• same Sxs as Central pontine myelinolysis.

Question 23

ACom stroke

-Sxs:

Answer 23

visual defects.

Question 24

PCom stroke

-Sxs:

Answer 24

CN 3 palsy.