Stroke

Question 1

What is the ABCD2 score

Answer 1

used to predict likelihood of stroke following TIA
Age >60
BP >140/90
Clinical features 
Duration 
Diabetes

Question 2

what is the full work up when it comes to stroke

Answer 2

Type of stroke
Size of stroke
Laterality of stroke
Cause of stroke

Question 3

What is the first line investigation for suspected stroke

Answer 3

CT non-contrast

Question 4

How does a haemorrhagic stroke appear on CT

Answer 4

bright white

Question 5

How does an ischaemic stroke appear on CT

Answer 5

dark spot

Question 6

what is TACS

Answer 6

total anterior circulation syndrome

Question 7

what are the features of TACS

Answer 7

hemiplegia of face, arm, leg
homonymous hemianopia
higher cerebral dysfunction

Question 8

what is PACS

Answer 8

partial anterior circulation syndrome

Question 9

what are the features of PACS

Answer 9

2/3 of TACS features
OR isolated cortical dysfunction
OR pure motor/sensory signs

Question 10

What is LACS

Answer 10

lacunar syndrome

Question 11

what are features of LACS

Answer 11

affects 2 of: face, arm, leg

pure sensory OR motor loss

Question 12

What metabolic conditions are associated with LACS

Answer 12

HTN
DM
^ cholesterol

Question 13

what is POCS

Answer 13

posterior circulation syndrome

Question 14

what are the features of POCS

Answer 14

CN palsies
BILATERAL sensory +/or motor deficits 
isolated homonymous hemianopia 
conjugate eye movement disorders
cortical blindness 
cerebellar deficits (DANISH)

Question 15

which cerebral hemisphere is dominant in most people

Answer 15

left

Question 16

what does damage to the dominant hemisphere usually affect

Answer 16

language

Question 17

what does damage to the non-dominant hemisphere usually affect

Answer 17

spatial awareness

Question 18

what are causes of stroke

Answer 18

atherothromboembolic
cardioembolic
small vessel disease
other

Question 19

what is the most common atherothromboembolic cause of stroke

Answer 19

carotid artery disease

Question 20

atherothromboembolism is a white/red plaque and is platelet/fibrin rich

Answer 20

white plaque

platelet rich

Question 21

what is the most common cardioembolic cause of stroke

Answer 21

atrial fibrillation

Question 22

cardioembolism is a white/red plaque and is platelet/fibrin rich

Answer 22

red plaque

fibrin rich

Question 23

what medication is used for atherothromboembolism

Answer 23

antiplatelet

Question 24

what medication is used for cardioembolic stroke

Answer 24

anticoagulant

Question 25

what can haemorrhagic stroke be divided into

Answer 25

primary and secondary intracerebral haemorrhage

Question 26

causes of primary intra cerebral haemorrhage

Answer 26

hypertension - deeper

amyloid angiopathy - peripheral

Question 27

causes of secondary intra cerebral haemorrhage

Answer 27

ateriovenous malformation
aneurysm
tumour
others

Question 28

what is the ABCDD of stroke prevention

Answer 28

anti thrombotic therapy 
blood pressure 
cholesterol 
diabetes
dont smoke

Question 29

what is the CHA2DS2VASc score

Answer 29

used for determining whether AF patients need anticoagulation

Question 30

what is the HAS-BLED score

Answer 30

bleeding risk - to identify reversible risk factors for anticoagulation

Question 31

Acute management of ischaemic stroke

Answer 31

ABCDE
CT/MRI
thrombolysis <4.5 hours of symptom onset
thrombectomy <6 hours of symptom onset
antiplatelets within 24 hours - aspirin 300mg + PPI for 2 weeks

Question 32

Acute management of haemorrhagic stroke

Answer 32

ABCDE
CT/MRI
control BP
reverse anticoagulation

Question 33

what is Weber’s syndrome

Answer 33

midbrain stroke syndrome

crossed over findings