| Test me | Slow Flow | Basics of squiggles | Can you see it? | Stroke Code to the ER: Localize the deficits |
|---|---|---|---|---|
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What is apraxia
The defines the inability to follow a motor command, when this inability is not due to a primary motor deficit or language impairment.
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What is TICI 2b
Anterograde reperfusion of more than half of the previoiusly occluded target artery ischemic territory (i.e. 2 major divisions)
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What is hyperpolarization
Occurs via efflux of K+ to cause intracellular voltage to become more negative
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What is the optic canal
Name the exit foramen of CN II
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What is left temporoparietal cortex including Wernicke's area, optic raditations, and somatosensory cortex
64yM found to be saying "meaningless" syllables and irrevelant phrases over and over and would not respond to any questions.
Exam: blink to threat present only on the left, slightly increased tone in right arm, grimaced more to pinprick L>R; responded to phrases with "yep yep" or "I don't know". No commands, no naming, no repetition |
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What is right frontal lesions, right thalamic or basal ganglia lesions, rarely lesions of the right midbrain.
Hemineglect is common in lesions to the right (nondominant parietal lobe). Name the other locations what will also result in left sided neglect.
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What is protection of airway, stopping rtPa, hold ACE-I, IV methyprednisone 125mg, IV Benadryl 50mg, IV famotidine 20mg.
Name the steps for management of angioedema after receiving rtPa
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What is delta (0-4Hz), theta: 4-8 Hz, Alpha 8-13Hz, Beta >13 Hz (13-30Hz), gamma >30Hz
Define the frequencies found on EEG's
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What is retinal ganglion cells --> optic nerve --> exits orbital apex via optic canal to enter cranial cavity --> partial crossing of fibers in optic chiasm --> synapse onto LGN --> projects to the primary visual cortex
Name the pathway of the LGN tract beginning with the retina.
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What is right primary motor cortex face and arm and adjacent right frontal lobe. R superior MCA infarct.
91yF with a. fib unable to get her arm through the left sleeve of her dress + slurred speech.
Exam: left facial weakness sparing the forehead, mild dysarthria, left arm pronator drive 4/5 strength in left arm, and brisk 3+ reflexes in left arm. Occasional extinction of the left side to double simultaneous visual or tactile stimulation. |
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What is hippus
This is defined as brief oscillations of pupillary size
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What is Age ≥ 18 years, NIHSS ≥6, Time from symptom onset to groin puuncture <6 hrs (up to 24 hr if evidence of sizable ischemic penumbra is seen on perfusion imaging, Good prestroke functional status, Alberta stroke program early CT score ≥6 on baseline CT scan, Presence of proximal intracranial artery occlusion
What are the criteria for acute endovascular therapy
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What is photic stimulation (progressive increasing frequency of flashing lights), and hyperventilation
Describe the methods used in provocation during EEG.
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What is a minority of fibers bypassing the LGN to enter the brachium of the superior colliculus. They project mainly to the pretectal area and superior colliculus which si important for pupillary light reflex and parasympathetics and association cortex.
Define the extrageniculate visual pathway
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What is left corticobulbar and corticospinal tracts in the internal capsule or ventral pons
84yF pw 2 episodes of slurred speech and R weakness onset 2 days. 3rd day: persistent dysarthria and right hemiplegia.
Exam: right facial weakness sparing the forehead, dysarthria, decreased right sided tone, 0/5 power in right arm and leg, right upgoing plantar response |
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What is the limbic memory structures located in the medial temporal lobes and medial diencephalon
If immediate recall is intact, then damage to these structures (name structures and location) will result in difficulty with recall in 1 to 5 minutes
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What is Significant head trauma or prior stroke in the previous 3 months
Symptoms suggest subarachnoid hemorrhage Arterial puncture at a noncompressible site in previous 7 days History of previous intracranial hemorrhage Intracranial neoplasm, AVM, or an aneurysm Recent intracranial or intraspinal surgery Elevated blood pressure (systolic greater than 185 mmHg or diastolic greater than 110 mmHg) Active internal bleeding Acute bleeding diathesis, including but not limited to Platelet count less than 100 000/mm^3 Heparin received within 48 hours resulting in abnormally elevated aPTT above the upper limit of normal Current use of anticoagulant with INR greater than 1.7 or PT greater than 15 seconds Current use of direct thrombin inhibitors or direct factor Xa inhibitors with elevated sensitive laboratory tests (e.g., aPTT, INR, platelet count, ECT, TT, or appropriate factor Xa activity assays) Blood glucose concentration less than 50 mg/dL (2.7 mmol/L) CT demonstrates multilobar infarction (hypodensity greater than a one-third cerebral hemisphere)
Name the contraindications to rtPa as defined by the AHA.
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What is stage 1: vertex waves and POSTS, stage 2: sleep spindles and K complexes, Slow wave sleep: diffuse, synchronized delta activity, REM: diffuse attenuation of activity with lateral eye movements in the frontal leads
Name the 4 stages of sleep and their defining characteristics
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What is bilateral occlusion of the PCA branches supplying the lingular gyri (inferior banks of calcarine fissures)
Describe the etiology and the lesion which would produce binocular altitudinal scotoma
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What is right temporoparietal lobe, including optic radiations.
61yM with an episode of L hand tingling lasting less than 1 hr.
Exam: denied anything was wrong and denied having deficits. Profound left visual neglect. On writing, moved pen in the air off to the right of the page. No blink to threat on the left, marked right gaze preference, and mildly decreased left nasolabial fold. Decreased left sided spontaneous movements. |
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What is appendicular ataxia caused by lesions of the cerebellar hemispheres and truncal ataxia caused by midline damage to the cerebellar vermis
This affects movements of the upper extremities and is usually caused by what while this affects proximal musculature, and is caused by what
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What is activated partial thromboplastin time, INR, ecarin clotting time, thrombin time or direct factor Xa activity AND >48 hrs since last dose
Name the labs needed if a patient is on a DOAC to determine eligibility for a rtPa per AHA/ASA.
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What is delta brush
This is defined as 8-20Hz fast activity overriding delta waves. May be normal in neonatal EEG.
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What is release phenomenon.
Patients with visual hallucinations in part or all of their visual fields caused by either ocular or central nervous systems lesions seeing objects, people or animals in the region of vision loss is called this
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What is Man in barrel syndrome: lesions in the contralateral motor cortex: proximal arm/trunk/proximal leg. ACA-MCA watershed infarcts.
52F with difficulty raising right arm.
Exam: decreased leftward fast phases of OKN. Left arm power: shrug 4+/5, deltoid 4-/5, triceps 4/5, biceps 4+/5, wrist extensors and fingers 5/5. Left leg power: hip flexors 4/5, 5/5 otherwise. Gait: veered to the left, tandem walking fell to the left |
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