Cerebrovascular Disease

MCQ

Dr. Kishore Kumar Ubrangala

All are risk factors for Stroke, except….

1.  High Blood Pressure 2.  Diabetes Mellitus 3.  Heart disease 4.  Low Homocysteine levels 5.  High Homocysteine levels

Charcot-Bouchard Aneurysms

Are responsible for: 1.  Ischemic stroke 2.  Sub-arachnoid Haemorrhage 3.  Intracerebral Haemorrhage 4.  All of the above

Headache – in SAH

Typically described as “______”Headache

SAH: True or False? Females more often are afflicted with

SAH

Drug of choice for Thrombolysis in Cerebral Thrombotic Stroke

1.  t-PA 2.  Urokinase 3.  Heparin 4.  Low molecular Heparin 5.  Streptokinase

Golden period for Stroke Thromolysis

1.  Twelve Hours 2.  One Hour 3.  Two Hours 4.  Three Hours 5.  Six Hours

SAH with 3rd Nerve Palsy indicates

1.  ACA aneurysm rupture 2.  Basilar artery aneurysm rupture 3.  PCA aneurysm rupture 4.  Internal Carotid artery aneurysm

rupture 5.  Anterior Choroidal artery aneurysm

rupture

Haemorrhagic Stroke constitutes..

1.  15% of all strokes 2.  30% 3.  50% 4.  60% 5.  85%

__% of SAH are due to rupture of Berry aneurysms

•  15% •  50% •  85% •  33% •  60%

Cavernous Sinus Thrombosis may produce all, except

1.  Headache 2.  LMN 7th palsy 3.  Ophthalmoplegia 4.  Papilloedema 5.  5th nerve involvement

Crossed Hemiplegia : Site of lesion

1.  Cerebral Cortex 2.  Corona Radiata 3.  Internal Capsule 4.  Brain Stem 5.  Spinal Cord

Wallenberg Syndrome: features

1. Ipsilateral 9th, 10th, 11th 2. Ipsilateral Horner’s 3. Ipsilateral Cerebellar signs 4. Ipsilateral Facial Pain & Temp loss 5. Contralateral Spinothalamic Sensory

Loss 6. Options 1,2,5 7. All of the above

TIA : Recovery of Neuological Recovery occurs within

1.  12 hours 2.  24 hours 3.  36 hours 4.  48 hours 5.  72 hours

Lacunar Strokes constitutes __% of Ischemic strokes

1.  10 2.  20 3.  40 4.  50 5.  60

Common sites for Intracerebral Haemorrhage : All, except

1.  Pons 2.  Cerebellum 3.  Thalamus 4.  Putamen 5.  Spinal Cord

TIA : Risk of Stroke in subsequent Year increased by__ fold

1.  3 2.  13 3.  20 4.  30 5.  50

Millard-Gubler Syndrome =

1.  6th & LMN 7th cranial nerve Ipsilateral & Contralateral Hemiparesis

2.  3rd nerve palsy Ipsilateral & Contralateral Hemiparesis

3.  12th nerve palsy Ipsilateral & Ipsilateral Hemiparesis

4.  Ipsilateral 3rd Nerve Palsy & Contralateral Hemitremor

Anterior Circulation Stroke: Typically causes

1.  Bilateral symptoms & signs 2.  Unilateral symptoms & signs

“Time lost is brain lost” Is the slogan for initiating which

modality of Stroke therapy? 1.  Anti-Platelets 2.  Anti-Coagulants 3.  Thrombolysis 4.  Statins 5.  Physiotherapy

Embolic Strokes in India : commonest underlying Etiologic

factor

1.  Rheumatic Valvular Disease 2.  Connective tissue disorder with

marantic endocarditis 3.  Infective endocarditis 4.  Ischemic Heart Disease

Ischemic Stroke: Decisive investigation before Thrombolysis

1.  Coagulation Studies 2.  Neuroimaging 3.  Electrocardiogram 4.  Echocardiogram 5.  Carotid angiography

Dense Hemiplegia is more likely with

1.  Internal capsular lesion 2.  Middle cerebral artery occlusion 3.  Internal carotid stem occlusion 4.  Anterior cerebral artery occlusion 5.  Options 1 & 3 6.  Options 2 & 3

Aphasia is statistically more common with

1. Left sided Cortical lesion 2. Right sided Cortical lesion 3. Left Internal Capsular lesion 4. Pontine Stem lesion 5. Medullary lesion

In Haemorrhagic Stroke

Elevated Blood Pressure 1.  Should be normalised as soon as

possible to prevent progression of bleeding.

2.  Should be reduced slowly in the initial few days to prevent drop in cerebral perfusion pressure.