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Neuropathology of acquired brain injury

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Neuropathology of acquired brain injury
Dan Myles
Quiz by Dan Myles, updated more than 1 year ago
Dan Myles
Created by Dan Myles over 8 years ago
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Resource summary

Question 1

Question
Which of the following is NOT an acquired brain injury (ABI)
Answer
  • Traumatic brain injury (Contusio/commotio cerebri, penetrating TBI)
  • Cerebrovascular accident (eg. Cerebral infarction/bleeding –TIA)
  • Postanoxic encephalopathy (eg. Complication after cardiac arrest, coma)
  • Brain tumor
  • Meningitis
  • Multiple Sclerosis

Question 2

Question
[blank_start]Traumatic Brain Injury[blank_end] is damage to living brain tissue caused by an external mechanical force or motion. It is characterized by a period of altered consciousness (amnesia or coma) that can be very brief (minutes) or very long (months/indefinitely).
Answer
  • Traumatic Brain Injury

Question 3

Question
Which of the following is correct?
Answer
  • Causesof traumatic brain injury •falling (43%) •car crash (22%) •violence (15%) •sport accidents (7%) Whoare at risk? •Men > Women •Young > Old •Urban > Rural people •Low socioeconomic status > High socioeconomic status
  • Causesof traumatic brain injury • car crash (43%) • falling (22%) • violence (15%) •sport accidents (7%) Whoare at risk? •Men < Women •Young < Old •Urban > Rural people •Low socioeconomic status > High socioeconomic status
  • Causesof traumatic brain injury • car crash (43%) • violence (22%) • falling (15%) •sport accidents (7%) Whoare at risk? •Men > Women •Young > Old •Urban > Rural people •Low socioeconomic status < High socioeconomic status
  • Causesof traumatic brain injury •falling (43%) •sport accidents (22%) •violence (15%) •car crash (7%) Whoare at risk? •Men > Women •Young > Old •Urban < Rural people •Low socioeconomic status > High socioeconomic status

Question 4

Question
Causesof traumatic brain injury •falling ([blank_start]43%[blank_end]) •car crash ([blank_start]22%[blank_end]) •violence ([blank_start]15%[blank_end]) •sport accidents ([blank_start]7%[blank_end])
Answer
  • 43%
  • 10%
  • 57%
  • 80%
  • 22%
  • 55%
  • 37%
  • 15%
  • 15%
  • 90%
  • 2%
  • 6%
  • 7%
  • 2%
  • 1%
  • 30%

Question 5

Question
Choose ALL correct answers
Answer
  • Closed TBI is more prevalent than Open TBI
  • Open TBI more often results in death
  • In general, Open TBI tend to damage localized areas of the brain whereas Closed TBI typically causes diffuse tissue damage. Thus, Open TBI results in more discrete and predictable disabilities whereas Closed TBI results often in disabilities which are generalized and highly variable.
  • Closed TBI more often results in death
  • Open TBI is more prevalent than Closed TBI

Question 6

Question
When considering TBI Damage caused by the effects of the physiological processes set in motion by the initial injury are known as:
Answer
  • Secondary Injuries
  • Tertiary Injuries
  • Cardiovascular events
  • Axonal Tearing/Shearing

Question 7

Question
Which of the following is NOT classified as a primary injury resulting from TBI
Answer
  • bruising of brain parenchyma (parenchyma = functional part of an organ)
  • laceration of nerve fibers
  • disruption of blood vessels
  • increased intracranial pressure

Question 8

Question
Choose the correct definition:
Answer
  • Contre-coup: (indirect) disruption of tissue located opposite to the site of impact.
  • Coup: disruption of the tissue at the point of impact
  • Deceleration: moving head against stationary object.
  • Acceleration: moving object against fixed head.
  • All of the above

Question 9

Question
The Formation of microscopic bubbles within the brain tissue as it is pulled away from the skull when the head suddenly stops or accelerates. This is known as
Image:
9120489d-40a0-4124-9afb-3be59fd02b95 (image/jpeg)
Answer
  • Microcavitation
  • Acceleration
  • Deceleration
  • Both Deceleration and Acceleration

Question 10

Question
[blank_start]Diffuse axonal injury[blank_end] involves the stretching, twisting and shearing of axons throughout the cortex
Answer
  • Diffuse axonal injury

Question 11

Question
Which hematoma occurs within the cortex
Answer
  • intracerebral
  • subdural
  • subarachnoid
  • Intra arachnoid

Question 12

Question
Seqcondary consequences of extracerebral (extracranial) hemorrhage
Answer
  • hypoxia (cerebral anoxia) in the brain due to massive loss of blood in other parts of the body or diminished lung capacity (lungcontusion/pneumothorax)
  • Hemorrhaging within the cerebral cortex, causing an increase in intracranial pressure, disturbed blood flow, coagulopathy

Question 13

Question
Coma patients generally lack a regular sleep/wake cycle
Answer
  • True
  • False

Question 14

Question
What is the name given to the state of confusion and memory disturbance that occurs immediately following traumatic brain injury?
Answer
  • Post traumatic amnesia
  • Retrograde amnesia
  • Anterograde amnesia
  • Post traumatic confabulation

Question 15

Question
Chose the correct standard assessment of TBI severity:
Answer
  • Mild: GCS (13 to 15), PTA (< 1 hour), LOC (< 30minutes) Moderate: GCS (9 to 12), PTA (30 minutes to 1 day), LOC (1 to 24 hours) Severe: GCS (< 8), PTA > 1 day, LOC >24 hours
  • Mild: GCS (< 8), PTA (< 1 hour), LOC (< 30minutes) Moderate: GCS (9 to 12), PTA (30 minutes to 1 day), LOC (1 to 24 hours) Severe: GCS (13 to 15), PTA > 1 day, LOC >24 hours
  • Mild: GCS (13 to 15), PTA (< 1 hour), LOC (< 30minutes) Moderate: GCS (9 to 12), PTA (> 1 day), LOC (1 to 24 hours) Severe: GCS (< 8), PTA > 1 week, LOC >24 hours
  • Mild: GCS (10 to 15), PTA (< 1 hour), LOC (< 8 hours) Moderate: GCS (8 to 10), PTA (30 minutes to 1 day), LOC (1 to 24 hours) Severe: GCS (< 8), PTA > 1 day, LOC >24 hours

Question 16

Question
What is the most common complaint 12 months after TBI?
Answer
  • "Forgetfulness"
  • "Mental Slowness"
  • "Depression"
  • "Headache"

Question 17

Question
[blank_start]Cardiovascular Accident (CVA)[blank_end] a focal neurological disorder of abrupt development due to a pathological process in the blood vessels.
Answer
  • Cardiovascular Accident (CVA)
  • Traumatic Brain Injury (TBI)
  • Huntington's Disease (HD)
  • Cerebrovascular Accident (CVA)

Question 18

Question
Which of the following risk factors concerning stroke are NOT true:
Answer
  • Increased aged, particularly 60 plus
  • Women > Men
  • Combination of smoking and high estrogen dosage in the contraceptive pill
  • Hypertension

Question 19

Question
Which of the following is NOT a RISK factor for stroke
Answer
  • Smoking
  • Hormone therapy
  • Hypotension, particularly in elderly
  • Drug and alcohol abuse
  • Healthy cardiovascular fitness

Question 20

Question
[blank_start]Atherosclerosis[blank_end] is a thickening of arterial walls characterized by the deposition of fatty material on their inner walls. Associated with hypertension, smoking, diabetes, obesity, and elevated levels of cholesterol.
Answer
  • Atherosclerosis
  • Apoptosis
  • Anosognosia
  • Atoroscelrosis

Question 21

Question
[blank_start]Thrombosis[blank_end] is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. An [blank_start]embolism[blank_end] is the lodging of a traveling intravascular mass within a blood vessel, this can cause a blockage in a blood vessel and obstruct blood flow. [blank_start]Hemorrhage[blank_end] is a rupture to a blood vessel causing blood to escape into the surrounding tissue.
Answer
  • Thrombosis
  • Embolism
  • Hemmorhage
  • embolism
  • thrombosis
  • hemmorhage
  • A hemorrhage
  • An embolism
  • Thrombosis

Question 22

Question
A [blank_start]transient ischemic[blank_end] attack is a brief episode of neurological dysfunction resulting from an interruption in the blood supply to the brain, sometimes as a precursor of a stroke. (Two words)
Answer
  • transient ischemic

Question 23

Question
An [blank_start]ischemic[blank_end] stroke involves the blockage of a blood vessel and subsequent reduction in the supply of oxygen to surrounding brain tissue
Answer
  • ischemic

Question 24

Question
Choose the correct incidence of stroke.
Answer
  • Ischemic strokes account for 80% of all strokes
  • Hemorrhagic strokes account for 80% of all strokes
  • Ischemic strokes account for 40% of all strokes
  • Hemorrhagic strokes account for 60% of all strokes

Question 25

Question
[blank_start]Hemorrhagic[blank_end] stroke may be cause by the weakening of a vessel wall due to pathological alterations, e.g aneurysm, or secondary to atherosclerosis.
Answer
  • Hemorrhagic

Question 26

Question
Type of bleeding that occurs within the skull but outside of the brain tissue, falls into three subtypes.
Answer
  • Extra-axial hemorrhage
  • Intra-axial hemorrhage

Question 27

Question
The three types of extra-axial hemorrhage include
Answer
  • subdural
  • subarachnoid
  • epidural or extradural
  • submyopic

Question 28

Question
Bleeding that occurs between the arachnoid mater and the dura is called a [blank_start]subdural[blank_end] hemorrhage
Answer
  • subdural

Question 29

Question
Mostly affect subcortical structures like thalamus, basal ganglia and brainstem. Mortality rate up to 70%-80%. This is true of:
Answer
  • Intra-axial hemorrhages
  • Extra-axial hemorrhages

Question 30

Question
[blank_start]Ischemia[blank_end] •Primary effects of infarct (occlusion) •Secondary effects(edema, physiological reactions etc.) [blank_start]Hemorrhage[blank_end] •Primary effects (leakage of blood, blood pressure) •Secondary ischemia (ischemic damage due to blood pressure)
Answer
  • Ischemia
  • Hemorrhage
  • Hemorrhage
  • Ischemia

Question 31

Question
Prosopagnosia is classically associated with lesions to
Answer
  • bilateral occipitotemporal regions, particularly the ventral region of the occipital association cortex and transition zones between the occipital and temporal lobe.
  • Occasionally observed in patients who have lesions restricted to the right hemisphere
  • Left lesioned patients will with more or less intact right hemispheres will often proceeding using a piecemeal approach, laboriously attending to single details but may ultimately make the correct identification.

Question 32

Question
If a stroke patient showed deficits in the recognition of this image, we would expect that: A) patients with left sided lesions resulting in deficit would have trouble identifying small details (D's) but could still readily identify the larger L shape. B) patients with right sided lesions resulting in deficit would have trouble identifying overall images (L) but could still readily identify the smaller D shapes. C) patients with right sided lesions resulting in deficit would have trouble identifying small details (D's) but could still readily identify the larger L shape. D) patients with left sided lesions resulting in deficit would have trouble identifying overall images (L) but could still readily identify the smaller D shapes.
Image:
3338ab79-1879-4490-bce6-7bf083b40ef8 (image/png)
Answer
  • A and B are true
  • C and D are true
  • A and D are true
  • B and D are true

Question 33

Question
The following deficits are more closely associated with damage to which side of the cortex? Visuoconstructive disorders Aprosody Auditory agnosia
Answer
  • Right
  • Left

Question 34

Question
The following deficits are consistent with injury in which hemisphere? Aphasia Acalculia Agraphia
Answer
  • Left
  • Right

Question 35

Question
Occlusion of the anterior cerebral artery is associated with which cluster of symptoms?
Answer
  • Dysexecutive disorders
  • Language disorders such as expressive or fluent aphasia
  • Hemianopsia

Question 36

Question
Occlusion of the middle cerebral artery is associated with which cluster of symptoms?
Answer
  • Dysexecutive disorders
  • Language disorders such as expressive or fluent aphasia
  • Hemianopsia

Question 37

Question
[blank_start]Diaschisis[blank_end] is a sudden loss (or change) of function in a portion of the brain connected to a distant, but damaged, brain area. The site of the originally damaged area and of the diaschisis are connected to each other by neurons. The loss of the damaged structure disrupts the function of the remaining intact systems and causes a physiological imbalance. The injury is produced by an acute focal disturbance in an area of the brain, from traumatic brain injury or stroke, for example. This is an example of [blank_start]a secondary[blank_end] brain damage.
Answer
  • Diaschisis
  • Dipole
  • Atherosclerosis
  • Ischemia
  • secondary
  • primary

Question 38

Question
[blank_start]Anosognosia[blank_end]: a patient’s lack of awareness or the underestimation of a specific deficit in functioning due to a brain lesion.
Answer
  • Anosognosia

Question 39

Question
[blank_start]Denial[blank_end] often demonstrate resistance and sometimes angry reaction when given feedback about their disability [blank_start]Anosognosia[blank_end] neurological lesion [blank_start]Denial[blank_end] psychological process protecting from depression or anxiety [blank_start]Anosognosia[blank_end] often show perplexity or indifference when receiving information about their deficits [blank_start]Anosognosia[blank_end] more stable in its manifestations [blank_start]Denial[blank_end] less stable in its manifestations
Answer
  • Denial
  • Anosognosia
  • Denial
  • Anosognosia
  • Denial
  • Anosognosia
  • Anosognosia
  • Denial
  • Anosognosia
  • Denial
  • Anosognosia
  • Denial

Question 40

Question
In stroke the the penumbra refers to:
Answer
  • The core zone, which is an area of severe ischemia (blood flow below 10% to 25%), the loss of oxygen and glucose results in rapid depletion of energy stores. Severe ischemia can result in necrosis of neurons and also of supporting cellular elements (glial cells) within this area.
  • A rim of mild to moderately ischemic tissue lying between tissue that is normally perfused and the area in which infarction is evolving, may remain viable for several hours. That is because the zone is supplied with blood by collateral arteries anastomosing with branches of the occluded vascular tree (see inset). However, even cells in this region will die if reperfusion is not established during the early hours since collateral circulation is inadequate to maintain the neuronal demand for oxygen and glucose indefinitely.

Question 41

Question
Neuropsychological assessment is usually conducted on patients within the acute phase of recovery.
Answer
  • True
  • False

Question 42

Question
Age is an important risk factor in the assessment of outcomes in TBI: Which of the following is NOT true
Answer
  • There is an increased risk of morbidity and mortality with increasing age, particularly after 65
  • Children tend to have better recovery from TBI than adults
  • Elderly patients experience more depression and anxiety as a result of TBI

Question 43

Question
A single head injury doubles the risk of subsequent head injury, a second TBI will increase the risk eightfold
Answer
  • True
  • False

Question 44

Question
Repeated concussions and head injuries are most common in
Answer
  • Athletes who engage in contact sport
  • The Elderly
  • Young children

Question 45

Question
Young people experience a higher incidence of TBI than older people
Answer
  • True
  • False

Question 46

Question
Patients with prior history of X tend to have poorer outcomes from TBI X significantly increases the likelihood of TBI TBI patients who experience damage to the frontotemporolimbic injury diminishes impulse control increasing the likelihood of X. What is X
Answer
  • Alcohol and substance abuse
  • Dementia
  • Cycling
  • Smoking

Question 47

Question
A worker is found unconscious on a building site with burns and scarring along arms a chest Epileptic seizures on admission to hospital Normal CT scan/MRI but abnormal EEG Generalized cognitive slowness at intake but intact verbal ability. The above case is suggestive of:
Answer
  • Cerebrovascular accident
  • Second Impact syndrome
  • Post traumatic stress disorder
  • Traumatic brain injury resulting from electrocution
  • Epilepsy
  • Normal cognitive deficit after recovery from major injury

Question 48

Question
Complete the following: TBI - Traumatic brain injury (example) CHI - [blank_start]Closed head injury[blank_end] PHI - [blank_start]Penetrating head injury[blank_end] ABI - [blank_start]Acquired brain injury[blank_end] GCS - [blank_start]Glasgow coma scale[blank_end] LOC - [blank_start]Loss of consciousness[blank_end] PTA - [blank_start]post traumatic amnesia[blank_end]
Answer
  • Closed head injury
  • Penetrating head injury
  • Acquired brain injury
  • Glasgow coma scale
  • Loss of consciousness
  • post traumatic amnesia

Question 49

Question
[blank_start]Concussion[blank_end] is a mild form of TBI
Answer
  • Concussion

Question 50

Question
A head injury always involves brain injury
Answer
  • True
  • False

Question 51

Question
Closed head injuries (CHI) can include (mark ALL correct)
Answer
  • Blunt force trauma to the head without skull fracture
  • Injury causing skull fracture and brain injury that pierces through the meningeal layers penetrating the brain
  • Injury causing skull fracture and brain injury, but no piercing of the meningeal layers
  • Impact of the brain against the skull. E.g Coup/Contra-Coup type injuries

Question 52

Question
Traumatic brain injury is the most common cause of brain injury in children and young adults.
Answer
  • True
  • False

Question 53

Question
Name as many secondary problems relating from traumatic brain injury as you can remember. Answers/suggestions below:
Answer
  • Ongoing hemorrhage
  • Ischemia (reduction/lack of blood supply)
  • Hypoxia (reduction/lack of oxygen)
  • Metabolic changes (e.g over supply of glucose)
  • Physiological changes (e.g altered concentration of neurotransmitters)
  • Diaschisis - loss of function in one area due to destruction of another distal brain area. This can eventually result in physiological and structural changes in the intact area.
  • Increase in intracranial pressure

Question 54

Question
More than half of all TBI in which population are a result of falls?
Answer
  • Over 64
  • Infants and young children
  • Both A and B

Question 55

Question
Who has the highest mortality rate in MVA's
Answer
  • Motorcyclists
  • Pedestrians
  • Motor vehicle passengers
  • Cyclists

Question 56

Question
Of the following age groups which show the highest incidence of TBI (choose three)
Answer
  • < 5 years
  • > 65 years
  • 15 - 24 years
  • 6 - 14 years
  • 25 - 34 years
  • 35 - 44 years
  • 45 - 55 years
  • 55 - 65 years

Question 57

Question
[blank_start]Men[blank_end] sustain twice as many head injuries as [blank_start]women[blank_end], with this difference most pronounced during peak trauma years (15 - 24). After 65 TBI are more numerous amongst [blank_start]women[blank_end].
Answer
  • Men
  • women
  • women

Question 58

Question
The incidence of TBI is approximately [blank_start]150[blank_end] in 100,000. However for mild TBI, the most common form of CHI many never seek medical care. Some of the highest rates have been observed in South Africa and South Australia.
Answer
  • 150
  • 322
  • 1,000
  • 9

Question 59

Question
When considering outcome predictions which of the following is NOT true
Answer
  • Some patients report more symptoms a year after the accident than after the first month
  • Physical symptoms usually decrease after one year, and are most severe in the acute phase
  • Emotional/social symptoms have typically decrease at one year

Question 60

Question
For patients with a short duration loss of consciousness (LOC) the GCS is an effective and accurate predictor of outcomes
Answer
  • True
  • False

Question 61

Question
PTA typically lasts about 4 times the length of a coma and correlates well with GCS.
Answer
  • True
  • False

Question 62

Question
Fill the following estimations of TBI outcome using PTA duration: Very Mild: [blank_start]< 5[blank_end] Minutes Mild: [blank_start]5 - 60[blank_end] Minutes Moderate: [blank_start]1-24[blank_end] Hours Severe: [blank_start]1 - 7[blank_end] Days Very Severe: [blank_start]1- 4[blank_end] weeks Extremely Severe: [blank_start]> 4[blank_end] weeks
Answer
  • < 5
  • <20
  • <30
  • 5 - 60
  • 20 - 60
  • 60 - 120
  • 5 - 120
  • 1-24
  • 24 - 42 hours
  • >38 hours
  • 1 - 38 hours
  • 1 - 7
  • 3
  • 1- 10
  • 5
  • 1- 4
  • 2 - 4
  • 1 - 6
  • > 4
  • > 6

Question 63

Question
Coma duration is a more accurate outcome predictor than length of post traumatic amnesia
Answer
  • True
  • False

Question 64

Question
Penetrating head injury is associated with a high rate of acute post injury seizure, occurring in up to [blank_start]80[blank_end]% of patients.
Answer
  • 80
  • 10
  • 20
  • 50

Question 65

Question
Memory impairments and changes in emotional and executive functioning are common in TBI, this appears to be related to high incidence of [blank_start]frontotemporal[blank_end] injury
Answer
  • frontotemporal
  • parietal
  • hippocampal
  • brainstem

Question 66

Question
Match the following types of hemorrhages with their locations Inside ventricular space - [blank_start]intraventricular[blank_end] [blank_start]Within the brain[blank_end] - intraparenchymal On the cortical surface - [blank_start]subarachnoid[blank_end] [blank_start]Outside the brain proper[blank_end] - extraparenchymal
Answer
  • intraventricular
  • ineterocerebral
  • extraventricular
  • ventrocentric
  • Within the substance of the brain
  • Within the brainstem
  • Within the parietal lobes
  • Outside the brain tissue
  • Against the brainstem
  • Within the parenchymus
  • Within the parenchymus
  • subarachnoid
  • subdural
  • epidural

Question 67

Question
The most life threatening effects of cerebral swelling are on [blank_start]brainstem[blank_end] structures concerned with vital functions
Answer
  • brainstem

Question 68

Question
A patient presents who has had a brief loss of consciousness following a head injury. They experienced a brief disturbance in memory and orientation following return of consciousness. Upon admission to hospital they received a GCS score of 13. A MRI follow up later that evening demonstrated no abnormalities. Following spending the night in hospital the patient underwent a brief NPA and performed mostly in above average ranges, though in the low average range for on a verbal retrieval task. They reported feeling a little tired but otherwise ok. This is likely an example of [blank_start]mild traumatic brain injury[blank_end].
Answer
  • mild traumatic brain injury
  • moderate traumatic brain injury
  • post concussion syndrome

Question 69

Question
What proportion of moderate TBI patients who were previously working are able to return to work?
Answer
  • 1/3
  • 1/4
  • 1/2
  • 2/3

Question 70

Question
What is the best approximation of the incidence of severe traumatic brain injury
Answer
  • Less than 10%
  • Between 10 - 15%

Question 71

Question
describe the course of recovery for severe TBI patients: [blank_start]After the first year[blank_end] - Improvements may continue from here on however progress gradually slows and will plateau below premorbid level. Improvements may continue, but are likely due to new learning and further development of compensational strategies than spontaneous recovery. [blank_start]After regaining consciousness[blank_end] - Patients often displays erratic behaviour, confusion, uncooperative, incoherence, anxiousness, aggressiveness, restlessness etc. PTA may continue for quite some time. [blank_start]In the weeks to months following[blank_end] - Fastest recovery is generally observed during this period. Tasks with a large yet simple attentional component tend to recover quickly but plateau after 6 months to one year. New learning progresses much slower, but ability to learn will not return to pre mordbid levels.
Answer
  • After the first year
  • Weeks to months
  • After regaining consciousness
  • In the weeks to months following
  • After regaining consciousness
  • After the first year
  • After regaining consciousness
  • In the weeks to months following
  • After the first year

Question 72

Question
Fluctuation in course of improvement in TBI patients with which form of deficit?
Answer
  • Memory Problems
  • Executive Dysfunction
  • Attentional Problems
  • Motor Dysfunction

Question 73

Question
Strokes are often painless
Answer
  • True
  • False

Question 74

Question
Tissue plasminogen activator (tPA) has been shown to be particularly effective if administered in the first few hours following what type of brain injury?
Answer
  • Ischemic Stroke
  • Hemorrhagic Stroke
  • Severe Traumatic Brain Injury
  • Concussion or mTBI

Question 75

Question
tPA - The medication used in the acute treatment of ischemic stroke stands for [blank_start]tissue plasminogen activator[blank_end]
Answer
  • tissue plasminogen activator

Question 76

Question
Which of the following types of brain injury has an incidence of roughly 150 in 100,000
Answer
  • Stroke
  • TBI
  • Both Stroke and TBI

Question 77

Question
Obstructive (Ischemic) Stroke is the most common form of stroke, accounting for approximately [blank_start]80%[blank_end] of all stroke. Thrombotic stroke accounts for up to [blank_start]75%[blank_end] of all obstructive stroke and between [blank_start]60 and 70%[blank_end] of stroke generally. Embolic stroke accounts for [blank_start]20 - 30%[blank_end] of all OBSTRUCTIVE strokes.
Answer
  • 80%
  • 20%
  • 50%
  • 40%
  • 75%
  • 15%
  • 30%
  • 45%
  • 60 and 70%
  • 80 and 90%
  • 10 and 20 %
  • 30 and 40%
  • 20 - 30%
  • 60 - 70%
  • 70 - 80%

Question 78

Question
[blank_start]Embolus[blank_end] - any intravascular mass capable of obstructing blood flood through the vasculature at a site distant from it's point of origin.
Answer
  • Embolus

Question 79

Question
[blank_start]Embolic[blank_end] strokes tend to be of sudden onset and without the warning precursors (e.g headache, transient ischemic attack) that can accompany other kinds of stroke.
Answer
  • Embolic
  • Thrombotic

Question 80

Question
The area of brain supplied by the [blank_start]middle cerebral[blank_end] artery is most commonly affected region in both thrombotic and embolic (ie ischemic) stroke.
Answer
  • middle cerebral
  • anterior cerebral
  • posterior cerebral

Question 81

Question
[blank_start]Embolic[blank_end] strokes are associated with hearth disease and usually occur at a younger age than [blank_start]thrombotic[blank_end] stroke.
Answer
  • Embolic
  • Thrombotic
  • thrombotic
  • embolic

Question 82

Question
For obstructive stroke patients with non-fluent aphasia, speech fluency usually returns after the [blank_start]first month[blank_end] if at all. By contrast confrontation naming is typically impaired at one month, with around one third of patients return to near normal levels by the [blank_start]sixth month[blank_end] of recovery.
Answer
  • first month
  • second month
  • sixth month
  • sixth month
  • first month
  • second month

Question 83

Question
[blank_start]Hemiplegia[blank_end] (lateralised paralysis) typically co-occurs with perceptual deficits. This co-occurrence is more common in [blank_start]left[blank_end] sided patients. However, hemiplegia and left sided inattention more commonly co-occur in patients with [blank_start]right[blank_end] sided lesions.
Answer
  • Hemiplegia
  • Hemianopsia
  • Hemilarisis
  • left
  • right
  • right
  • left

Question 84

Question
Depression following a stroke is more prevalent [blank_start]after the first six months.[blank_end]
Answer
  • after the first six months.
  • in the first six months

Question 85

Question
Depression involving a primarily indifferent or apathetic attitude is more characteristic of [blank_start]right[blank_end] sided stroke.
Answer
  • right
  • left

Question 86

Question
Post-hospital development of depression is more common in [blank_start]right[blank_end]-sided stoke patients. Whereas the incidence of depression in [blank_start]left[blank_end] sided stroke patients tends to decrease after the acute stages.
Answer
  • right
  • left
  • left
  • right

Question 87

Question
At four years which of the following aspects is most predictive of quality of life?
Answer
  • Depression
  • Ability to walk
  • Memory
  • Ability to perform ADLs?

Question 88

Question
[blank_start]Hemorrhagic[blank_end] stroke is the most devastating form of stroke, and carries the worst prognosis.
Answer
  • Hemorrhagic
  • Embolic
  • Thrombotic

Question 89

Question
Hemorrhagic strokes have a mortality rate approximately between [blank_start]35 and 50%[blank_end] within the first 30 days. Although, mortality due to hemorrhagic stroke has been reduced over the years.
Answer
  • 35 and 52%
  • 6 and 11%
  • 59 and 80%

Question 90

Question
[blank_start]5 - 10%[blank_end] of all strokes are due to ruptured aneurysms.
Answer
  • 5 - 10%
  • 20 - 30%
  • Approximately 80%

Question 91

Question
Vasospasm, the constriction of surrounding blood vessels secondary to hemorrhage, can can result in ischemia and infarction.
Answer
  • True
  • False

Question 92

Question
Caused by a blockage in blood vessels but leaving no permanent change in cognitive function. Which of the following best accounts for these symptoms?
Answer
  • Hemorrhagic Stroke
  • Ischemic Stroke
  • Transient Ischemic Attacks
  • Transient Myocardial Infarction

Question 93

Question
Stroke evolves following TIA in approximately [blank_start]30%[blank_end] of patients, and [blank_start]10 - 15%[blank_end] of all strokes are preceded by a TIA.
Answer
  • 10 - 15%
  • 5%
  • 30%
  • 30%
  • 10%
  • 50%
  • 70%

Question 94

Question
A 62 year-old building inspector was charged with criminal misconduct for issuing hundreds of building permits for plans that did not meet requirements. He responded with a profound depression, for which he was hospitalized. On NP evaluation he was alert, oriented, verbose, illogical but not irrational and feeling hurt and puzzled in regards to his convictions as he felt he had done his work well. While his scores on predominately verbal tests were generally well above average, his performances on construction tests were confused, and both free hand and copy drawing were confused and distorted. On questioning he provided a history of flu like symptoms occurring just before he began giving the improper permits. CT scan revealed an old lesion. This description is most consistent with:
Answer
  • Concussion
  • "Silent" Right sided stroke
  • Left-sided hemorrhagic stroke
  • Depression

Question 95

Question
"Silent" strokes are more common in the left hemisphere than the right hemisphere.
Answer
  • True
  • False
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