Ischemic Stroke Overview
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Ischemic Stroke Overview

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Questions and Answers

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?

    <p>To salvage tissue and increase intracranial pressure</p> Signup and view all the answers

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

    <p>Hypoglycemia</p> Signup and view all the answers

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

    <p>Brain attack</p> Signup and view all the answers

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

    <p>2 to 3 hours</p> Signup and view all the answers

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

    <p>High calcium levels</p> Signup and view all the answers

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

    <p>Hemorrhagic strokes</p> Signup and view all the answers

    How many people on average have a stroke each year?

    <p>795,000</p> Signup and view all the answers

    What is the purpose of the Cincinnati Prehospital Stroke Scale?

    <p>To assess patients suspected of having a stroke</p> Signup and view all the answers

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

    <p>Patient smiles with noticeable drooping on one side</p> Signup and view all the answers

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

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

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

    <p>Conduct a CT scan to determine stroke type</p> Signup and view all the answers

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

    <p>A patient with ongoing symptoms</p> Signup and view all the answers

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

    <p>Medical</p> Signup and view all the answers

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

    <p>Patient of a specific age category</p> Signup and view all the answers

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

    <p>Patient experiencing severe chest pain</p> Signup and view all the answers

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

    <p>Patient requesting the test</p> Signup and view all the answers

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

    <p>Patient who has unusual physical characteristics</p> Signup and view all the answers

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

    <p>Stop the P.A. insertion immediately.</p> Signup and view all the answers

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

    <p>Every 15 minutes.</p> Signup and view all the answers

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

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

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

    <p>125 to 160.</p> Signup and view all the answers

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

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

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

    <p>Bleeding directly into the brain tissue</p> Signup and view all the answers

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

    <p>Pulmonary embolism</p> Signup and view all the answers

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

    <p>Sudden and severe headache</p> Signup and view all the answers

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

    <p>Management of ABCs (Airway, Breathing, Circulation)</p> Signup and view all the answers

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

    <p>Above 200 mm Hg</p> Signup and view all the answers

    What is a transient ischemic attack (TIA)?

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

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

    <p>10% to 15%</p> Signup and view all the answers

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

    <p>Duration of symptoms: TIA duration ≤59 minutes</p> Signup and view all the answers

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

    <p>4.1%</p> Signup and view all the answers

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

    <p>0–3</p> Signup and view all the answers

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

    <p>Sudden intense headache</p> Signup and view all the answers

    What is the initial imaging procedure for a suspected aneurysm?

    <p>CT scan without contrast</p> Signup and view all the answers

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

    <p>Maintain airway and oxygenation</p> Signup and view all the answers

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

    <p>Maintain systolic BP between 90-140 mmHg</p> Signup and view all the answers

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

    <p>Elastic stockings or pneumatic compression devices</p> Signup and view all the answers

    What is the first step in assessing a stroke patient?

    <p>Interview the patient or bystanders</p> Signup and view all the answers

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

    <p>Cincinnati Prehospital Stroke Scale</p> Signup and view all the answers

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

    <p>To rule out hemorrhage and determine management</p> Signup and view all the answers

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

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

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

    <p>Prothrombin time (PT) and international normalized ratio (INR)</p> Signup and view all the answers

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

    <p>Perform lumbar puncture</p> Signup and view all the answers

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

    <p>7 minutes</p> Signup and view all the answers

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

    <p>Time-dependent therapeutic intervention</p> Signup and view all the answers

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

    <p>110 mmHg</p> Signup and view all the answers

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

    <p>180 mmHg</p> Signup and view all the answers

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

    <p>Female gender</p> Signup and view all the answers

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

    <p>60-80 mmHg</p> Signup and view all the answers

    Which intervention is NOT recommended when managing increased intracranial pressure?

    <p>Administer hypoglycemic agents</p> 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?

    <p>Every 15 minutes</p> Signup and view all the answers

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

    <p>Antiepileptic therapy</p> Signup and view all the answers

    What percentage of strokes is attributed to spontaneous subarachnoid hemorrhage?

    <p>3% to 5%</p> Signup and view all the answers

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