stroke and TIA

1. 1stroke is an [blank_start]acute[blank_end] onset of brain dysfunction with focal neurological deficits caused by an alteration in cerebrovascular [blank_start]blood[blank_end] supply lasting >[blank_start]24[blank_end] hours

   1. Aacute
   2. Bchronic
   3. Cblood
   4. Dnerve
   5. Eoxygen
   6. F24
   7. G1
   8. H6
   9. I12
   10. J48
2. 2which of the following is not a cause of stroke?

   1. Aarterial embolism
   2. Bhaemorrhage
   3. Cischaemia
   4. Dsmall vessel thrombosis
   5. Esudden drop in BP in younger patients
   6. Fcarotid artery dissection
   7. Gvasculitis
   8. Hantiphospholipid syndrome
   9. Ithrombocytopenia
   10. JCADASIL
3. 3in the UK there are [blank_start]110,000[blank_end] new and [blank_start]30,000[blank_end] recurrent strokes each year. the incidence is higher in [blank_start]males[blank_end] of [blank_start]African[blank_end] origin. it is the [blank_start]third[blank_end] most common cause of death in the UK and accounts for [blank_start]4-5[blank_end]% of the NHS budget

   1. A110,000
   2. B90,000
   3. C80,000
   4. D100,000
   5. E30,000
   6. F40,000
   7. G50,000
   8. H20,000
   9. Imales
   10. Jfemales
   11. KAfrican
   12. LAsian
   13. MCaucasian
   14. Nthird
   15. Osecond
   16. Pfourth
   17. Qfifth
   18. R4-5
   19. S1-2
   20. T2-3
   21. U3-4
   22. V5-6
4. 4which of the following is not a risk factor for stroke

   1. AAF
   2. Bhypertension
   3. Csmoking
   4. Dprevious TIA/stroke
   5. Epatent foramen ovale
   6. Fsleep apnoea
   7. Galcohol
   8. Hhypercholesterolaemia
   9. Ipatent ductus arteriosus
   10. Jcarotid artery stenosis
5. 5the name of the score used to calculate risk of stroke in a patient with AF is [blank_start]CHADSVASC[blank_end]

   1. ACHADSVASC
   2. BHASBLED
   3. CROSIER
   4. DGLASGOW
6. 6which of the following is not a criteria of the CHADSVASC score?

   1. Acongestive cardiac failure
   2. Bhypertension
   3. Cage >75
   4. Dage >60
   5. Ediabetes
   6. Fprior stroke or TIA
   7. Gvascular disease e.g.previous MI, peripheral artery disease
   8. Hfemale
   9. Iatrial fibrillation
7. 7? is a rare inherited cause of stroke and vascular dementia caused by a defective NOTCH3 gene. There are multiple small brain infarcts which present as migraines and depression in teenage years to the 30's where there are often TIA's and strokes

   1. Aantiphospholipid syndrome
   2. BCADASIL
   3. Cthrombophilia
   4. Dvasculitis
8. 8the scoring criteria used to calculate risk of major bleeding from anticoagulation in AF is [blank_start]HASBLED[blank_end]

   1. AHASBLED
9. 9which of the following is not a criteria of HASBLED?

   1. Ahypertension
   2. Babnormal liver or renal function
   3. Cstroke
   4. Dbleeding
   5. Elabile INR
   6. Felderly >65
   7. Gdrugs or alcohol
   8. Hsmoking
10. 10of all stroke [blank_start]85[blank_end]% are ischaemic and [blank_start]15[blank_end]% are hemorrhagic

    1. A85
    2. B95
    3. C75
    4. D65
    5. E55
    6. F15
    7. G5
    8. H25
    9. I35
    10. J45

11. 11ischaemic stroke can either be [blank_start]thrombotic[blank_end] (a clot forms within a cerebral blood vessel e.g. [blank_start]LACS[blank_end]) or [blank_start]embolic[blank_end] (clot breaks off and becomes lodged in cerebral blood vessels e.g. [blank_start]TACS[blank_end] or [blank_start]PACS[blank_end]). this results in [blank_start]vascular occlusion[blank_end] which starves brain cells of [blank_start]blood[blank_end] and therefore [blank_start]oxygen[blank_end] and nutrients leading to cell death. infarcted tissue eventually undergoes [blank_start]liquefaction necrosis[blank_end] and is removed by [blank_start]macrophages[blank_end] with development of [blank_start]parenchymal volume loss.[blank_end]
    
    ischaemia also directly results in dysfunction of cerebral vasculature with breakdown of [blank_start]the BBB[blank_end] occurring [blank_start]4-6[blank_end] hours after infarction. [blank_start]proteins[blank_end] and water then flood into the [blank_start]extracellular[blank_end] space leading to [blank_start]vasogenic oedema[blank_end]. this produces greater levels of brain swelling that peaks at [blank_start]3-5[blank_end] days and resolve over several weeks.
    
    regions with [blank_start]lower[blank_end] cerebral blood flow are referred to as the [blank_start]core[blank_end] and these cells die within [blank_start]minutes[blank_end] of stroke onset. zones of [blank_start]marginal perfusion[blank_end] are called the ischaemic [blank_start]pneumbra[blank_end] and tissue here can remain viable for [blank_start]several hours[blank_end].

    1. Athrombotic
    2. BLACS
    3. Cembolic
    4. DTACS
    5. EPACS
    6. Fblood
    7. Gvascular occlusion
    8. Hoxygen
    9. Iliquefaction necrosis
    10. Jmacrophages
    11. Kparenchymal volume loss.
    12. Lthe BBB
    13. M4-6
    14. Nproteins
    15. Oextracellular
    16. Pvasogenic oedema
    17. Q3-5
    18. Rlower
    19. Score
    20. Tminutes
    21. Umarginal perfusion
    22. Vpneumbra
    23. Wseveral hours
12. 12every minute an ischaemic stroke is left untreated the average patient loses 1.9 million neurons.

    1. ATrue
    2. BFalse
13. 13which of the following is not a cause of haemorrhagic stroke?

    1. Aaneurysm
    2. BAVM (arteriovenous malformation)
    3. Cvasculitis
    4. Damyloidosis
    5. Esarcoidosis
    6. Ftumour
    7. Ghypertension
    8. Hanti-coagulants
    9. Ianti-platelets
    10. JSLE
14. 14ing the BAMFORD classification match each of the following presentations with the type of stroke.
    
    the patient presents with dysphasia, homonymous hemianopia and left sided weakness - [blank_start]TACS[blank_end]
    
    the patient presents with right sided weakness and homonymous hemianopia - [blank_start]PACS[blank_end]
    
    the patient presents with weakness of the right face, arm and leg - [blank_start]LACS[blank_end]
    
    the patient presents with weakness of the left arm - [blank_start]PACS[blank_end]
    
    the patient presents with right sided cranial nerve palsy with left sided weakness - [blank_start]POCS[blank_end]
    
    the patient presents with homonymous hemianopia, loss of consciousness and a disorder or conjugate eye movements - [blank_start]POCS[blank_end]
    
    the patient presents with dysphasia - [blank_start]PACS[blank_end]
    
    the patient presents with homonymous hemianopia, neglect and right sided numbness - [blank_start]TACS[blank_end]
    
    the patient presents with ataxic hemiparesis - [blank_start]LACS[blank_end]
    
    the patient presents with loss of co-ordination and balance - [blank_start]POCS[blank_end]

    1. ATACS
    2. BPOCS
    3. CPACS
    4. DLACS
    5. ETACS
    6. FPACS
    7. GPOCS
    8. HLACS
    9. ITACS
    10. JPACS
    11. KPOCS
    12. LLACS
    13. MTACS
    14. NPACS
    15. OPOCS
    16. PLACS
    17. QTACS
    18. RPACS
    19. SPOCS
    20. TLACS
    21. UTACS
    22. VPACS
    23. WPOCS
    24. XLACS
    25. YTACS
    26. ZPACS
    27. AAPOCS
    28. ABLACS
    29. ACTACS
    30. ADPACS
    31. AEPOCS
    32. AFLACS
    33. AGTACS
    34. AHPACS
    35. AIPOCS
    36. AJLACS
    37. AKTACS
    38. ALPACS
    39. AMPOCS
    40. ANLACS
15. 15match the artery to the picture

    

    1. Aanterior cerebral artery
    2. Binternal carotid artery
    3. Canterior communicating artery
    4. Dmiddle cerebral artery
    5. Eposterior communicating artery
    6. Fposterior cerebral artery
    7. Gbasilar artery
    8. Hvertebral artery
    9. Iposterior inferior cerebellar artery
    10. Janterior inferior cerebellar artery
16. 16match the answers with the blanks

    

    1. Afrontal lobe
    2. Bparietal lobe
    3. Ctemporal lobe
    4. Doccipital lobe
    5. Ecerebellum
    6. Fhearing
    7. Gfacial recognition
    8. Hco-ordination
    9. Ivision
    10. Jreading
    11. Klanguage
    12. Lbody awareness
    13. Mtaste
    14. Ntouch and pressure
    15. Omotor control
    16. Pconcentration, planning, problem solving
    17. Qspeech
    18. Rsmell
17. 17damage to the wernicke's area will result in [blank_start]receptive[blank_end] aphasia, damage to broca's area will result in [blank_start]expressive[blank_end] aphasia

    1. Areceptive
    2. Bexpressive
    3. Cexpressive
    4. Dreceptive
18. 18a right sided stroke is more likely to produce aphasia and other language deficits in 95% of people

    1. ATrue
    2. BFalse
19. 19hemispatial neglect which is the inability to process and perceive stimuli on one side of the body is more common following a [blank_start]right[blank_end] sided stroke. this is because the [blank_start]right[blank_end] hemisphere is more specialised for spatial perception and memory unlike the [blank_start]left[blank_end] hemisphere which is more specialised for language. this mean the [blank_start]right[blank_end] hemisphere is able to compensate for damage to the [blank_start]left[blank_end] but not vice versa.

    1. Aright
    2. Bleft
    3. Cright
    4. Dleft
    5. Eleft
    6. Fright
    7. Gright
    8. Hleft
    9. Ileft
    10. Jright
20. 20quadraplegia, disturbance of gaze and vision and locked in syndrome are symptoms of what kind of stroke?

    1. Acerebral
    2. Bbrainstem
    3. Clacunar
    4. Dcerebellar
21. 21a stroke in which of the following areas would not be classified as a lacunar stroke?

    1. Abasal ganglia
    2. Binternal capsule
    3. Cthalamus
    4. Dhypothalamus
    5. Epons
22. 22which of the following is not a symptom of cerebral infarct?

    1. Acontralateral seonsory loss of hemiplegia
    2. Bdysphasia
    3. Chomonymous hemianopia
    4. Dvisuo-spatial deficit
    5. Edysphagia
23. 23which of the following is not a symptom of lacunar infarcts

    1. Aataxic hemiparesis
    2. Bweakness
    3. Cnumbness
    4. Ddysarthria
    5. Edysphasia
24. 24which of the following is not a symptom of cerebellar infarct

    1. Aloss of balance and co-ordination
    2. Bloss of vision
    3. Cproblems with speech and communication
    4. Ddysphagia
    5. Eweakness
    6. Fdizziness
25. 25which of the following would be the least appropriate investigation for stroke

    1. Abloods
    2. BECG
    3. CCXR
    4. DCT head
    5. ECTPA
    6. FECHO and carotid doppler
    7. GMRA
    8. HMRI head
26. 26match the description to the CT

    

    1. Anormal
    2. Bischaemic stroke
    3. Chaemorrhagic stroke
    4. Dsubarachnoid haemorrhage
    5. Ebrain tumour
27. 27which score is used to differentiate between strokes and stroke mimics?

    1. AROSIER
    2. BGENEVA
    3. CRANSON
    4. DALVARADO
28. 28which would be the treatment of choice for hemorrhagic stroke

    1. Athrombolysis
    2. Balteplase
    3. Csurgical intervention
    4. Danti-platelets
    5. Eanti-coagulation
29. 29thrombolysis should be carried out for ischaemic stroke within [blank_start]4[blank_end] hours

    1. A4
30. 30for ischaemic stroke treat with [blank_start]300[blank_end]mg [blank_start]aspirin[blank_end] for up to [blank_start]14[blank_end] days before switching to [blank_start]clopidogrel[blank_end]. if the patient has AF you may also want to consider giving [blank_start]anti-coagulants[blank_end] e.g. [blank_start]epixiban[blank_end] but not for at least [blank_start]7[blank_end] days after the initial event.

    1. A300
    2. B200
    3. C400
    4. D500
    5. E600
    6. Faspirin
    7. Gclopidogrel
    8. Hticagrelor
    9. Iticlopidine
    10. J14
    11. K7
    12. L10
    13. M28
    14. Nclopidogrel
    15. Oaspirin
    16. Pticagrelor
    17. Qticlopidine
    18. Ranti-coagulants
    19. Santi-platelets
    20. Tbeta-blockers
    21. UACE inhibitors
    22. Vepixiban
    23. Wramipril
    24. Xclopidogrel
    25. Ybisoprolol
    26. Z7
    27. AA10
    28. AB14
    29. AC28
31. 31which of the following are not contraindications for thrombolysis?

    1. Aage >75
    2. Bhaemorrhage
    3. Cmajor surgery or serious trauma within the last 2 weeks
    4. Dserious head injury within the last 3 months
    5. Elumbar puncture in the last week
    6. FBP >185/110
    7. Gglucose <2.7 or >22
    8. HINR >1.7
    9. Ipositive pregnancy test
    10. Jprevious haemorrhage within the last 6 months
32. 32match the prognosis to the bamford stroke classification type

    

    1. ATACS
    2. BPACS
    3. CLACS
    4. DPOCS
33. 33put the following stroke types in order of likelihood of recurrence from highest to lowest:
    [blank_start]PACS[blank_end]
    [blank_start]POCS[blank_end]
    [blank_start]TACS[blank_end]
    [blank_start]LACS[blank_end]

    1. APACS
    2. BPOCS
    3. CTACS
    4. DLACS
34. 34what index can be used to calculate the impact of disability or impairment on activities of daily living? [blank_start]barthels[blank_end]

    1. Abarthels
35. 35following a stroke patients will not be allowed to drive for at least [blank_start]1[blank_end] month

    1. A1
36. 36TIA is a transient focal neurological deficit caused by a change in vascular supply to the brain lasting <[blank_start]24[blank_end] hours (typically <[blank_start]30[blank_end] minutes)

    1. A24
    2. B2
    3. C6
    4. D12
    5. E48
    6. F30
    7. G10
    8. H20
    9. I40
    10. J50
37. 37[blank_start]50[blank_end]/100,000 people are affected each year by a first TIA. it is more common in [blank_start]men[blank_end] of [blank_start]African[blank_end] descent and is rare <[blank_start]60[blank_end]. about [blank_start]15[blank_end]% of stroke victims have had a previous TIA.

    1. A50
    2. B100
    3. C500
    4. D1000
    5. Emen
    6. Fwomen
    7. GAfrican
    8. HAsian
    9. ICaucasian
    10. J60
    11. K50
    12. L55
    13. M65
    14. N70
    15. O75
    16. P45
    17. Q15
    18. R10
    19. S20
    20. T25
    21. U30
38. 38which of the following is not a risk factor for TIA?

    1. Ahypertension
    2. Bsmoking
    3. Cdiabetes
    4. Dheart disease
    5. Epolycythaemia vera
    6. Fhyperlipidaemia
    7. Gcarotid artery occlusion
    8. Halcohol
    9. Iclotting disorders
    10. Jliver cirrhosis
39. 39which of the following is not a cause of TIA?

    1. Acranial arteritis
    2. BSLE
    3. Csyphilis
    4. Dpolycythaemia
    5. Esickle cell
    6. Fmyeloma
    7. Gatrial myxoma
    8. Hcardioembolism post MI
    9. Iatherothrombus from the carotid artery
    10. Jthalassaemia
40. 40which of the following would not be a symptoms of anterior circulation TIA

    1. Adysphasia
    2. Bhemiparesis
    3. Camaurosis fugax
    4. Ddysarthria
    5. Ehemianopic visual loss
    6. Fone sided sensory loss
    7. Gtransient global amnesia
41. 41which of the following is not a symptom of posterior circulation TIA

    1. Adiplopia
    2. Bvertigo
    3. Cvomiting
    4. Ddysphagia
    5. ELOC
    6. Fataxia
    7. Gtransient global amnesia
    8. Hone sided sensory loss
    9. Idysarthria
    10. Jhemiparesis
42. 42which of the following would not be a TIA differential

    1. Aepilepsy
    2. Btodds paralysis
    3. Chypoglycaemia
    4. DMS
    5. Eperipheral neuropathy
    6. FGCA
    7. Gtransient global amnesia
    8. Hsyncope due to arrhythmia
    9. Imalignant hypertension
    10. Jstroke
43. 43for treatment of TIA commence on [blank_start]aspirin[blank_end] [blank_start]300[blank_end]mg for [blank_start]14[blank_end] days then switch to [blank_start]clopidogrel[blank_end] [blank_start]75[blank_end]mg. begin [blank_start]straight away[blank_end] after initial event.

    1. Aaspirin
    2. Bclopidogrel
    3. C300
    4. D100
    5. E200
    6. F150
    7. G250
    8. H14
    9. I7
    10. J10
    11. K28
    12. Lclopidogrel
    13. Maspirin
    14. N75
    15. O25
    16. P50
    17. Q100
    18. R150
    19. Sstraight away
    20. T7 days
    21. U14 days
    22. Vone month
44. 44following a TIA a patient will not be allowed to drive for [blank_start]1[blank_end] month

    1. A1
45. 45the score used to predict the short term risk of stroke following a TIA is [blank_start]ABCD2[blank_end]

    1. AABCD2
46. 46which of the following is not a criteria of the ABCD2 score?

    1. Aage >60
    2. Bage >75
    3. CBP >140 systolic or >90 diastolic
    4. Dunilateral weakness
    5. Espeech impairment
    6. Fduration >60 minutes
    7. Gduration 10-59 minutes
    8. Hdiabetes

Description

LTC Quiz on stroke and TIA, created by Rebecca Finn on 01/03/2018.

Author

Rebecca Finn

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