SCRN Study Exam 69 Questions and Answers
(100% Correct Solutions)
A 67yo man with a hx of HTN, DM, HLD, and smoking presents to the ED. CC of persistent
dizziness q1week that has become so severe he now has double vision, N/V. His wife tells you
she noticed a L facial droop and slurring. Pt reports weakness in L arm and leg. He denies HA or
SZ. Head CT was negative for acute bleed. Upon returning to the room he has become
increasingly obtunded and difficult to arouse. You notice he now has a nystagmus and slightly
dysconjugate gaze. His exam appears to be worsening now with R/L extremity weakness in
addition to his L hemiparesis. What type of stroke syndrome are you concerned he may be
having?
a. Wallenberg's stroke
b. Dissection of the R internal carotid artery
c. acute basilar artery occlusion
d. Superior cerebellar artery stroke
c
You are assessing a 35yo M who has been in a motor vehicle crash, and during the exam you
notice he has some abnormal eye exam findings and weakness in the R arm and leg (arm more
than leg). He has droopiness of the L eyelid and his pupils are unequal. The L pupil is 3mm in
diameter and the right is 5MM. Both pupils are round and reactive to light. Although it is a hot,
humid day, he is not sweating from the heat. What stroke syndrome do you suspect your patient
is experiencing?
a. Weber's syndrome
b. Amaurosis fugax
c. Locked-in syndrome
d. Horner's syndrome
d
What is a possible cause of Horner's syndrome?
a. Occlusion of the MCA
b. Dissection of the L ICA
c. Dissection of the R ICA
d. ACA stroke
b
,a patient presents with central retinal artery occlusion. As you evaluate the neuroimaging, you
recognize that the most likely etiology is artery-to-thrombosis from which artery?
a. Basilar artery
b. Middle cerebral artery
c. Posterior inferior cerebellar artery
d. Carotid artery
d
A patient is admitted to the emergency department with acute symptoms of hemiparesis, hemi-
sensory loss, gaze preference, and aphasia. Which vessel do you suspect is involved in the
stroke?
a. ACA
b. MCA
c. PCA
d. PICA
b
What cluster of symptoms is consistent with Weber's syndrome?
a. Ipsilateral cranial nerve 3 palsy, contralateral hemiparesis
b. Ipsilateral cranial nerve 4 and 6 palsy, contralateral hemiparesis
c. Contralateral cranial nerve 4 and 6 palsy, ipsilateral hemiparesis
d. ipsilateral cranial nerve 5 paly, ipsilateral ataxia
a
a patient is admitted with symptoms consistent with Weber's syndrome. If the stroke is ischemic,
which arteries would you suspect might have caused the stroke?
a. Carotid artery
b. Middle cerebral artery
c. Posterior cerebral artery
d. Basilar artery
c
A patient presents with vertical gaze palsy, pupils mid-dilated with light dissociation, and
convergence-retraction nystagmus. This cluster of symptoms is consistent with which of the
following symptoms?
a. Weber's syndrome
b. Horner's syndrome
, c. Parinaud's syndrome
d. Wallenberg's syndrome
c
Parinaud's syndrome results from which part of the brain?
a. Dorsal midbrain
b. Lateral medulla
c. Ventral pons
d. Posterior inferior cerebellum
a
You are caring for a pt who has had multiple small strokes in the watershed territory between the
ACA and MCA. Which of the following is the most likely etiology for this type of stroke?
a. Embolus of cardiac origin
b. Carotid artery atherosclerosis
c. Vasculitis
d. Severe hypotension
d
Which arteries are occluded in Wallenberg's syndrome?
a. MCA
b. PICA
c. ICA
d. PCA
b
A patient with lacunar ischemic stroke, with a hx of HTN, CAD, and DM is being discharged
from the hospital. What BP goal will you teach them to target?
a. SBP <150
b. SBP <140
c. SBP <130
d. SBP <120
c
A nurse is educating a patient about modifiable ischemic stroke risk factors. Select the correct
answer that indicates modifiable risk factors
(100% Correct Solutions)
A 67yo man with a hx of HTN, DM, HLD, and smoking presents to the ED. CC of persistent
dizziness q1week that has become so severe he now has double vision, N/V. His wife tells you
she noticed a L facial droop and slurring. Pt reports weakness in L arm and leg. He denies HA or
SZ. Head CT was negative for acute bleed. Upon returning to the room he has become
increasingly obtunded and difficult to arouse. You notice he now has a nystagmus and slightly
dysconjugate gaze. His exam appears to be worsening now with R/L extremity weakness in
addition to his L hemiparesis. What type of stroke syndrome are you concerned he may be
having?
a. Wallenberg's stroke
b. Dissection of the R internal carotid artery
c. acute basilar artery occlusion
d. Superior cerebellar artery stroke
c
You are assessing a 35yo M who has been in a motor vehicle crash, and during the exam you
notice he has some abnormal eye exam findings and weakness in the R arm and leg (arm more
than leg). He has droopiness of the L eyelid and his pupils are unequal. The L pupil is 3mm in
diameter and the right is 5MM. Both pupils are round and reactive to light. Although it is a hot,
humid day, he is not sweating from the heat. What stroke syndrome do you suspect your patient
is experiencing?
a. Weber's syndrome
b. Amaurosis fugax
c. Locked-in syndrome
d. Horner's syndrome
d
What is a possible cause of Horner's syndrome?
a. Occlusion of the MCA
b. Dissection of the L ICA
c. Dissection of the R ICA
d. ACA stroke
b
,a patient presents with central retinal artery occlusion. As you evaluate the neuroimaging, you
recognize that the most likely etiology is artery-to-thrombosis from which artery?
a. Basilar artery
b. Middle cerebral artery
c. Posterior inferior cerebellar artery
d. Carotid artery
d
A patient is admitted to the emergency department with acute symptoms of hemiparesis, hemi-
sensory loss, gaze preference, and aphasia. Which vessel do you suspect is involved in the
stroke?
a. ACA
b. MCA
c. PCA
d. PICA
b
What cluster of symptoms is consistent with Weber's syndrome?
a. Ipsilateral cranial nerve 3 palsy, contralateral hemiparesis
b. Ipsilateral cranial nerve 4 and 6 palsy, contralateral hemiparesis
c. Contralateral cranial nerve 4 and 6 palsy, ipsilateral hemiparesis
d. ipsilateral cranial nerve 5 paly, ipsilateral ataxia
a
a patient is admitted with symptoms consistent with Weber's syndrome. If the stroke is ischemic,
which arteries would you suspect might have caused the stroke?
a. Carotid artery
b. Middle cerebral artery
c. Posterior cerebral artery
d. Basilar artery
c
A patient presents with vertical gaze palsy, pupils mid-dilated with light dissociation, and
convergence-retraction nystagmus. This cluster of symptoms is consistent with which of the
following symptoms?
a. Weber's syndrome
b. Horner's syndrome
, c. Parinaud's syndrome
d. Wallenberg's syndrome
c
Parinaud's syndrome results from which part of the brain?
a. Dorsal midbrain
b. Lateral medulla
c. Ventral pons
d. Posterior inferior cerebellum
a
You are caring for a pt who has had multiple small strokes in the watershed territory between the
ACA and MCA. Which of the following is the most likely etiology for this type of stroke?
a. Embolus of cardiac origin
b. Carotid artery atherosclerosis
c. Vasculitis
d. Severe hypotension
d
Which arteries are occluded in Wallenberg's syndrome?
a. MCA
b. PICA
c. ICA
d. PCA
b
A patient with lacunar ischemic stroke, with a hx of HTN, CAD, and DM is being discharged
from the hospital. What BP goal will you teach them to target?
a. SBP <150
b. SBP <140
c. SBP <130
d. SBP <120
c
A nurse is educating a patient about modifiable ischemic stroke risk factors. Select the correct
answer that indicates modifiable risk factors
