Ischemic Stroke Overview

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What percentage of all strokes are ischemic events?

95%

85% (correct)

50%

75%

What typically initiates the ischemic cascade in the brain?

Intracranial pressure increase

Hemorrhage

Infection

Thrombosis or embolus (correct)

Which clinical manifestation is associated with ischemic stroke?

Gradual loss of balance

Sudden unilateral weakness (correct)

Severe chest pain

Sudden visual loss in both eyes

What is the primary goal of acute stroke management?

To salvage tissue and increase intracranial pressure Signup and view all the answers

Which symptom is part of the assessment to determine if it is a stroke or a mimic?

Hypoglycemia Signup and view all the answers

What is the common term used to refer to a stroke to emphasize its urgency?

Brain attack Signup and view all the answers

What is the maximum time duration for arterial occlusion to prevent ischemic brain injury?

2 to 3 hours Signup and view all the answers

Which of the following is NOT listed as a risk factor for stroke?

High calcium levels Signup and view all the answers

Which type of stroke has a higher mortality rate compared to ischemic strokes?

Hemorrhagic strokes Signup and view all the answers

How many people on average have a stroke each year?

795,000 Signup and view all the answers

What is the purpose of the Cincinnati Prehospital Stroke Scale?

To assess patients suspected of having a stroke Signup and view all the answers

Which of the following is considered an abnormal finding under the Cincinnati Prehospital Stroke Scale for facial droop?

Patient smiles with noticeable drooping on one side Signup and view all the answers

What does an abnormal arm drift indicate when assessed using the Cincinnati Prehospital Stroke Scale?

Patient's arm drifts downward more on one side Signup and view all the answers

What should be done within 10 minutes of a stroke patient's arrival at the emergency department?

Conduct a CT scan to determine stroke type Signup and view all the answers

Which of the following criteria would include a patient for TTE testing?

A patient with ongoing symptoms Signup and view all the answers

Which classification is NOT a type of stroke identified in the assessment process?

Medical Signup and view all the answers

What is NOT a reason for excluding a patient from TTE testing?

Patient of a specific age category Signup and view all the answers

Which criterion signifies a patient with emergency conditions that would exclude them from TTE?

Patient experiencing severe chest pain Signup and view all the answers

Which of the following is an inclusive criterion for TTE testing?

Patient requesting the test Signup and view all the answers

What condition might prevent a patient from being eligible for a TTE?

Patient who has unusual physical characteristics Signup and view all the answers

What is the recommended action if complications arise during P.A. insertion?

Stop the P.A. insertion immediately. Signup and view all the answers

How often should vital signs be monitored in the first 2 hours following P.A. insertion?

Every 15 minutes. Signup and view all the answers

What should be documented as part of the management of fluid during P.A. treatment?

Time of start of treatment in response to P.A. Signup and view all the answers

What blood pressure range should be maintained in patients receiving prophylactic treatment?

125 to 160. Signup and view all the answers

What should be done for hypotension in patients undergoing P.A. treatment?

Lower the BP by 20% within a reasonable timeframe. Signup and view all the answers

What is the primary characteristic of intracerebral hemorrhage (ICH)?

Bleeding directly into the brain tissue Signup and view all the answers

Which of the following is NOT a cause of intracerebral hemorrhagic stroke?

Pulmonary embolism Signup and view all the answers

What symptom is typically associated with a rapidly deteriorating condition in patients with ICH?

Sudden and severe headache Signup and view all the answers

Which initial assessment and management step should be prioritized for ICH patients?

Management of ABCs (Airway, Breathing, Circulation) Signup and view all the answers

When aiming to manage blood pressure in a patient with ICH, what is the target systolic blood pressure?

Above 200 mm Hg Signup and view all the answers

What is a transient ischemic attack (TIA)?

An episode of neurological dysfunction due to focal cerebral ischemia Signup and view all the answers

What percentage of TIA patients may experience a stroke within three months?

10% to 15% Signup and view all the answers

Which of the following is included in the ABCD assessment tool for TIA?

Duration of symptoms: TIA duration ≤59 minutes Signup and view all the answers

An ABCD score of 4 to 5 indicates what risk for stroke within two days?

4.1% Signup and view all the answers

What total ABCD2 score indicates that hospital observation may be unnecessary?

0–3 Signup and view all the answers

Which symptom is commonly described as the 'worst headache of my life'?

Sudden intense headache Signup and view all the answers

What is the initial imaging procedure for a suspected aneurysm?

CT scan without contrast Signup and view all the answers

Which of the following is a critical intervention for patients with suspected decreased level of consciousness?

Maintain airway and oxygenation Signup and view all the answers

What management strategy is appropriate for maintaining blood pressure in suspected aneurysm cases?

Maintain systolic BP between 90-140 mmHg Signup and view all the answers

Which of the following approaches is recommended for preventing venous thromboembolism (VTE) in patients?

Elastic stockings or pneumatic compression devices Signup and view all the answers

What is the first step in assessing a stroke patient?

Interview the patient or bystanders Signup and view all the answers

Which tool is recommended for a brief neurological examination during a stroke assessment?

Cincinnati Prehospital Stroke Scale Signup and view all the answers

What is the purpose of performing an immediate CT scan in suspected stroke cases?

To rule out hemorrhage and determine management Signup and view all the answers

Which procedure is NOT recommended in the immediate diagnostic workup for stroke?

Magnetic resonance imaging (MRI) Signup and view all the answers

Which of the following tests evaluates blood clotting in stroke patients?

Prothrombin time (PT) and international normalized ratio (INR) Signup and view all the answers

If a CT scan shows no blood in a suspected Subarachnoid Hemorrhage case, what is the next procedure?

Perform lumbar puncture Signup and view all the answers

How long does it typically take to score a patient using the NIHSS?

7 minutes Signup and view all the answers

What is the primary goal for stroke care for patients arriving within 6 hours of symptom onset?

Time-dependent therapeutic intervention Signup and view all the answers

What is the target mean arterial pressure (MAP) for patients without elevated intracranial pressure?

110 mmHg Signup and view all the answers

What is the upper limit for systolic blood pressure that requires monitoring of intracranial pressure?

180 mmHg Signup and view all the answers

Which of the following is a common risk factor for aneurysmal subarachnoid hemorrhage?

Female gender Signup and view all the answers

What should be the cerebral perfusion pressure (CPP) maintained in patients with elevated intracranial pressure?

60-80 mmHg Signup and view all the answers

Which intervention is NOT recommended when managing increased intracranial pressure?

Administer hypoglycemic agents Signup and view all the answers

How often should a patient be re-evaluated if blood pressure is lowered to a target of 160/90 mmHg?

Every 15 minutes Signup and view all the answers

Which of the following is a common treatment for clinical seizures?

Antiepileptic therapy Signup and view all the answers

What percentage of strokes is attributed to spontaneous subarachnoid hemorrhage?

3% to 5% Signup and view all the answers