Podcast
Questions and Answers
What is the most common cause of stroke in developed countries?
What is the most common cause of stroke in developed countries?
Which type of stroke is mainly associated with unrecognized or poorly controlled hypertension?
Which type of stroke is mainly associated with unrecognized or poorly controlled hypertension?
Which classification of stroke is characterized by a focal neurologic deficit lasting less than 24 hours?
Which classification of stroke is characterized by a focal neurologic deficit lasting less than 24 hours?
What is the primary contraindication for thrombolytic therapy with rt-PA in the management of Atherosclerotic stroke (Thrombotic stroke)?
What is the primary contraindication for thrombolytic therapy with rt-PA in the management of Atherosclerotic stroke (Thrombotic stroke)?
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What is the indicated medical therapy for preventing neurologic deterioration due to vasospasm in the management of Subarachnoid haemorrhage?
What is the indicated medical therapy for preventing neurologic deterioration due to vasospasm in the management of Subarachnoid haemorrhage?
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What is the general recommendation for anticoagulation treatment in the management of Embolic stroke (cardiogenic embolus)?
What is the general recommendation for anticoagulation treatment in the management of Embolic stroke (cardiogenic embolus)?
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What is a major risk factor for stroke?
What is a major risk factor for stroke?
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Which imaging study is more sensitive for early brain infarction diagnosis?
Which imaging study is more sensitive for early brain infarction diagnosis?
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What is the goal of treatment for specific stroke management?
What is the goal of treatment for specific stroke management?
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Ischemic stroke accounts for 80 – 90% of all stroke in developed countries. The three main subtypes of ischemic stroke are a) ________ b) ________ and c) ________.
Ischemic stroke accounts for 80 – 90% of all stroke in developed countries. The three main subtypes of ischemic stroke are a) ________ b) ________ and c) ________.
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Transient Ischemic attack: TIAs are focal neuralgic deficit lasting less than ________ confined to an area of brain perfused by specific artery.
Transient Ischemic attack: TIAs are focal neuralgic deficit lasting less than ________ confined to an area of brain perfused by specific artery.
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Reversible Ischemic neurologic deficit: sudden onset focal neurologic deficit which lasts for more than ________, but the neurologic deficit recovers / resolves.
Reversible Ischemic neurologic deficit: sudden onset focal neurologic deficit which lasts for more than ________, but the neurologic deficit recovers / resolves.
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_______ factors for stroke include demographic factors (higher in men and older age), Pyramid DM, hypertension, hyperlipidemia, cardiac issues (atrial fibrillation, myocardial infarction, congestive heart failure), substance abuse (acute alcohol abuse, smoking)
_______ factors for stroke include demographic factors (higher in men and older age), Pyramid DM, hypertension, hyperlipidemia, cardiac issues (atrial fibrillation, myocardial infarction, congestive heart failure), substance abuse (acute alcohol abuse, smoking)
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Fever raises suspicion for ______ aetiologies
Fever raises suspicion for ______ aetiologies
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CT shows complete infarction after 24 hours, MRI is more sensitive for early brain infarction ______
CT shows complete infarction after 24 hours, MRI is more sensitive for early brain infarction ______
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Thrombolytic therapy with rt-PA is indicated for patients who present within _______ of onset of stroke
Thrombolytic therapy with rt-PA is indicated for patients who present within _______ of onset of stroke
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Heparin and warfarin use in the management of Atherosclerotic stroke (Thrombotic stroke) is _______
Heparin and warfarin use in the management of Atherosclerotic stroke (Thrombotic stroke) is _______
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Anticoagulation with heparin should be initiated when the acute phase of stroke is _______
Anticoagulation with heparin should be initiated when the acute phase of stroke is _______
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Saccular aneurysms in the management of prevention of further stroke are _______ surgically
Saccular aneurysms in the management of prevention of further stroke are _______ surgically
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Match the following stroke classification with their descriptions:
Match the following stroke classification with their descriptions:
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Match the following stroke classification with their associated percentage of occurrence:
Match the following stroke classification with their associated percentage of occurrence:
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Match the following stroke classification with their progression characteristics:
Match the following stroke classification with their progression characteristics:
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Match the following stroke risk factors with their association:
Match the following stroke risk factors with their association:
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Match the following imaging studies with their purpose in stroke diagnosis:
Match the following imaging studies with their purpose in stroke diagnosis:
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Match the following stroke subtype with its associated physical examination findings:
Match the following stroke subtype with its associated physical examination findings:
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Match the following stroke management measures with their corresponding types of stroke:
Match the following stroke management measures with their corresponding types of stroke:
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Match the following imaging studies with their corresponding stroke diagnosis:
Match the following imaging studies with their corresponding stroke diagnosis:
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Match the following supportive measures with their corresponding types of stroke:
Match the following supportive measures with their corresponding types of stroke:
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Match the following medication therapies with their corresponding types of stroke:
Match the following medication therapies with their corresponding types of stroke:
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Study Notes
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Complete stroke: sudden onset of focal neurological deficit, with no improvement or worsening, often related to cerebral infarction
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Major risk factors for stroke include demographic factors (higher in men and older age), Pyramid DM, hypertension, hyperlipidemia, cardiac issues (atrial fibrillation, myocardial infarction, congestive heart failure), substance abuse (acute alcohol abuse, smoking)
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Goals in managing a patient with stroke: assessment and maintenance of vital functions, determination of presumptive diagnosis of stroke subtype, confirmation of stroke subtype, and management of the patient
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Initial assessment and maintenance of vital functions: maintenance of airway and ventilation, control of blood pressure, control of body temperature, fluid management
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Assessment of vital functions: maintain airway and ventilation - monitor intubated patients or provide supplemental oxygen if needed; control blood pressure - monitor and correct both hypotension and hypertension; control body temperature - fever worsens stroke prognosis, so maintain appropriate temperature; fluid management - maintain euvolemic state and establish IV access using normal saline, avoid glucose solutions
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Determining presumptive diagnosis of stroke subtype: important clinical features include mode of onset and pattern of progression, prior history of TIAs, associated symptoms, and risk factors
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Physical examination findings may suggest stroke subtype: Embolic/Ischemic stroke - absent/reduced peripheral pulses, neck bruit, cardiac abnormalities; Haemorrhagic stroke - ophthalmoscopic examination for papilledema or retinal haemorrhage; Fever raises suspicion for infectious aetiologies
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Imaging studies: CT or MRI for identification or exclusion of hemorrhagic stroke and other conditions mimicking stroke; CT shows complete infarction after 24 hours, MRI is more sensitive for early brain infarction diagnosis
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Investigations: Carotid Doppler studies, angiography, echocardiography, ECG, CBC, ESR, VDRL, HIV infection tests, fasting blood glucose, lipid profile, coagulation profile
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Management of specific stroke: goal of treatment - interruption of further brain damage, prevention and management of complications; general measures - admit patients for close follow-up, continue follow-up and maintenance of vital functions.
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Complete stroke: sudden onset of focal neurological deficit, with no improvement or worsening, often related to cerebral infarction
-
Major risk factors for stroke include demographic factors (higher in men and older age), Pyramid DM, hypertension, hyperlipidemia, cardiac issues (atrial fibrillation, myocardial infarction, congestive heart failure), substance abuse (acute alcohol abuse, smoking)
-
Goals in managing a patient with stroke: assessment and maintenance of vital functions, determination of presumptive diagnosis of stroke subtype, confirmation of stroke subtype, and management of the patient
-
Initial assessment and maintenance of vital functions: maintenance of airway and ventilation, control of blood pressure, control of body temperature, fluid management
-
Assessment of vital functions: maintain airway and ventilation - monitor intubated patients or provide supplemental oxygen if needed; control blood pressure - monitor and correct both hypotension and hypertension; control body temperature - fever worsens stroke prognosis, so maintain appropriate temperature; fluid management - maintain euvolemic state and establish IV access using normal saline, avoid glucose solutions
-
Determining presumptive diagnosis of stroke subtype: important clinical features include mode of onset and pattern of progression, prior history of TIAs, associated symptoms, and risk factors
-
Physical examination findings may suggest stroke subtype: Embolic/Ischemic stroke - absent/reduced peripheral pulses, neck bruit, cardiac abnormalities; Haemorrhagic stroke - ophthalmoscopic examination for papilledema or retinal haemorrhage; Fever raises suspicion for infectious aetiologies
-
Imaging studies: CT or MRI for identification or exclusion of hemorrhagic stroke and other conditions mimicking stroke; CT shows complete infarction after 24 hours, MRI is more sensitive for early brain infarction diagnosis
-
Investigations: Carotid Doppler studies, angiography, echocardiography, ECG, CBC, ESR, VDRL, HIV infection tests, fasting blood glucose, lipid profile, coagulation profile
-
Management of specific stroke: goal of treatment - interruption of further brain damage, prevention and management of complications; general measures - admit patients for close follow-up, continue follow-up and maintenance of vital functions.
-
Complete stroke: sudden onset of focal neurological deficit, with no improvement or worsening, often related to cerebral infarction
-
Major risk factors for stroke include demographic factors (higher in men and older age), Pyramid DM, hypertension, hyperlipidemia, cardiac issues (atrial fibrillation, myocardial infarction, congestive heart failure), substance abuse (acute alcohol abuse, smoking)
-
Goals in managing a patient with stroke: assessment and maintenance of vital functions, determination of presumptive diagnosis of stroke subtype, confirmation of stroke subtype, and management of the patient
-
Initial assessment and maintenance of vital functions: maintenance of airway and ventilation, control of blood pressure, control of body temperature, fluid management
-
Assessment of vital functions: maintain airway and ventilation - monitor intubated patients or provide supplemental oxygen if needed; control blood pressure - monitor and correct both hypotension and hypertension; control body temperature - fever worsens stroke prognosis, so maintain appropriate temperature; fluid management - maintain euvolemic state and establish IV access using normal saline, avoid glucose solutions
-
Determining presumptive diagnosis of stroke subtype: important clinical features include mode of onset and pattern of progression, prior history of TIAs, associated symptoms, and risk factors
-
Physical examination findings may suggest stroke subtype: Embolic/Ischemic stroke - absent/reduced peripheral pulses, neck bruit, cardiac abnormalities; Haemorrhagic stroke - ophthalmoscopic examination for papilledema or retinal haemorrhage; Fever raises suspicion for infectious aetiologies
-
Imaging studies: CT or MRI for identification or exclusion of hemorrhagic stroke and other conditions mimicking stroke; CT shows complete infarction after 24 hours, MRI is more sensitive for early brain infarction diagnosis
-
Investigations: Carotid Doppler studies, angiography, echocardiography, ECG, CBC, ESR, VDRL, HIV infection tests, fasting blood glucose, lipid profile, coagulation profile
-
Management of specific stroke: goal of treatment - interruption of further brain damage, prevention and management of complications; general measures - admit patients for close follow-up, continue follow-up and maintenance of vital functions.
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Description
Test your knowledge of the aetiological classification of stroke including ischemic stroke and hemorrhagic stroke, as well as their subtypes such as embolic, thrombotic, large vessel disease, small vessel disease, and miscellaneous causes.