Stroke (questions & answers) A+
graded
In the case of a suspected stroke, what is the most appropriate next diagnostic step, and best
therapy? - correct answer ✔✔ Most appropriate next step:
CT scan of the head (no contrast)
Best therapy:
thrombolytics
Acute onset of focal neurologic deficits is typical for what? - correct answer ✔✔ CVA
(cerebrovascular accident), aka stroke
What are management priorities in the case of a suspected CVA? - correct answer ✔✔
Management priorities include:
- ABCs (airway, breathing, and circulation)
- stabilization of vitals
- a careful history and physical to distinguish CVA from other etiologies which may present
similarly, such as hypoglycemia.
What is used to quickly determine whether the CVA is ischemic or hemorrhagic? - correct
answer ✔✔ Non-contrast CT scan
If the event is ischemic, the patient may be a candidate for what? - correct answer ✔✔
Thrombolytic administration
,What is the goal when a pt presents with a suspected CVA? - correct answer ✔✔ The goal is to
complete an evaluation and, if the patient is eligible, initiate treatment within 60 minutes of the
patient's arrival to the ED.
We must be cognizant that... - correct answer ✔✔ "Time is Brain Tissue."
Define stroke. - correct answer ✔✔ The rapid development of the loss of brain function due to a
disturbance in the blood vessels supplying the brain. It is also referred to as a CVA.
Define transient ischemic attack (TIA). - correct answer ✔✔ Occurs when the blood supply to a
particular area of the brain is interrupted. It is often referred to as a "mini stroke," and the
symptoms typically last minutes to hours, but resolve within 24 hours.
What are thrombolytics? - correct answer ✔✔ Medications that act to degrade clots and are
used in the treatment of myocardial infarctions, pulmonary embolisms, and strokes.
What is the National Institutes of Health (NIH) stroke scale? - correct answer ✔✔ A bedside
assessment tool that provides a reproducible, quantitative measurement of the stroke-related
neurologic deficit.
True or false:
Stroke is a serious and common disorder that affects over 795,000 persons in the United States
each year. - correct answer ✔✔ True
True or false:
Stroke remains the fourth leading cause of death in the United States, and the number one
cause for disability. - correct answer ✔✔ True
20% of affected persons will die within 1 year.
, Many surviving victims are left with neurologic deficits and may be unable to care for
themselves.
Symptoms of stroke vary widely depending on what 3 things? - correct answer ✔✔ - the type of
infarct
- the location
- the amount of brain involved
Strokes are classified as either... - correct answer ✔✔ ischemic or hemorrhagic
What percent of strokes are ischemic due to the blockage of a blood vessel secondary to
thrombosis or embolism? - correct answer ✔✔ 80%
Ischemic strokes are generally seen in which age group, and present with what symptoms? -
correct answer ✔✔ They are generally seen in patients older than the age of 50, and present
with the sudden onset of focal neurologic deficits.
Hemorrhagic strokes are usually seen in which age group, and are due to what processes? -
correct answer ✔✔ Hemorrhagic strokes are typically seen in younger patients and are due to
intraparenchymal or subarachnoid cerebral vessel bleeding.
What are symptoms of a transient ischemic attack (TIA)? - correct answer ✔✔ - neurological
deficit resolving within 24 hours
- highly correlated with future thrombotic stroke
What are symptoms of a dominant hemisphere ischemic stroke? - correct answer ✔✔ -
contralateral numbness and weakness
- contralateral visual field cut
graded
In the case of a suspected stroke, what is the most appropriate next diagnostic step, and best
therapy? - correct answer ✔✔ Most appropriate next step:
CT scan of the head (no contrast)
Best therapy:
thrombolytics
Acute onset of focal neurologic deficits is typical for what? - correct answer ✔✔ CVA
(cerebrovascular accident), aka stroke
What are management priorities in the case of a suspected CVA? - correct answer ✔✔
Management priorities include:
- ABCs (airway, breathing, and circulation)
- stabilization of vitals
- a careful history and physical to distinguish CVA from other etiologies which may present
similarly, such as hypoglycemia.
What is used to quickly determine whether the CVA is ischemic or hemorrhagic? - correct
answer ✔✔ Non-contrast CT scan
If the event is ischemic, the patient may be a candidate for what? - correct answer ✔✔
Thrombolytic administration
,What is the goal when a pt presents with a suspected CVA? - correct answer ✔✔ The goal is to
complete an evaluation and, if the patient is eligible, initiate treatment within 60 minutes of the
patient's arrival to the ED.
We must be cognizant that... - correct answer ✔✔ "Time is Brain Tissue."
Define stroke. - correct answer ✔✔ The rapid development of the loss of brain function due to a
disturbance in the blood vessels supplying the brain. It is also referred to as a CVA.
Define transient ischemic attack (TIA). - correct answer ✔✔ Occurs when the blood supply to a
particular area of the brain is interrupted. It is often referred to as a "mini stroke," and the
symptoms typically last minutes to hours, but resolve within 24 hours.
What are thrombolytics? - correct answer ✔✔ Medications that act to degrade clots and are
used in the treatment of myocardial infarctions, pulmonary embolisms, and strokes.
What is the National Institutes of Health (NIH) stroke scale? - correct answer ✔✔ A bedside
assessment tool that provides a reproducible, quantitative measurement of the stroke-related
neurologic deficit.
True or false:
Stroke is a serious and common disorder that affects over 795,000 persons in the United States
each year. - correct answer ✔✔ True
True or false:
Stroke remains the fourth leading cause of death in the United States, and the number one
cause for disability. - correct answer ✔✔ True
20% of affected persons will die within 1 year.
, Many surviving victims are left with neurologic deficits and may be unable to care for
themselves.
Symptoms of stroke vary widely depending on what 3 things? - correct answer ✔✔ - the type of
infarct
- the location
- the amount of brain involved
Strokes are classified as either... - correct answer ✔✔ ischemic or hemorrhagic
What percent of strokes are ischemic due to the blockage of a blood vessel secondary to
thrombosis or embolism? - correct answer ✔✔ 80%
Ischemic strokes are generally seen in which age group, and present with what symptoms? -
correct answer ✔✔ They are generally seen in patients older than the age of 50, and present
with the sudden onset of focal neurologic deficits.
Hemorrhagic strokes are usually seen in which age group, and are due to what processes? -
correct answer ✔✔ Hemorrhagic strokes are typically seen in younger patients and are due to
intraparenchymal or subarachnoid cerebral vessel bleeding.
What are symptoms of a transient ischemic attack (TIA)? - correct answer ✔✔ - neurological
deficit resolving within 24 hours
- highly correlated with future thrombotic stroke
What are symptoms of a dominant hemisphere ischemic stroke? - correct answer ✔✔ -
contralateral numbness and weakness
- contralateral visual field cut
