[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 3

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Cerebrovascular Diseases Ischemic stroke- Part 3

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Question 1

Emboli of what size are large enough to occlude stem of MCA ?

A	0.5 - 1 mm
B	1 - 2 mm
C	2 - 3 mm
D	3 - 4 mm

Question 1 Explanation:

Emboli of the size of 3 - 4 mm are large enough to occlude stem of MCA.

Question 2

Which of the following is the most common cause of cerebral cardioembolism ?

A	Rheumatic heart disease with atrial fibrillation
B	Nonrheumatic atrial fibrillation
C	Recent MI
D	Mitral valve prolapse

Question 2 Explanation:

Nonrheumatic atrial fibrillation is the most common cause of cerebral embolism. Others are mural thrombus, myocardial infarction, dilated cardiomyopathy, mitral stenosis, mechanical valve, bacterial endocarditis. Mitral valve prolapse is not a source of emboli unless prolapse is severe

Question 3

CHADS2 score is calculating risk of stroke in ?

A	Nonvalvular atrial fibrillation
B	Mitral valve prolapse
C	Patent foramen ovale
D	Mechanical heart value

Question 4

Maximum points in CHADS2 score is for ?

A	Age
B	Hypertension
C	Congestive heart failure
D	Stroke or TIA

Question 4 Explanation:

CHADS2 score is calculated by summing of points for age >75 years (1), hypertension (1), congestive heart failure (1), diabetes (1), and stroke or TIA (2).

Question 5

Which of the following location of recent transmural myocardial infarction is mostly the source of cerebral emboli ?

A	Anteroapical ventricular wall
B	Inferior ventricular wall
C	Posterior ventricular wall
D	Lateral ventricular wall

Question 5 Explanation:

Recent transmural MI involving anteroapical ventricular wall is a source of cerebral emboli

Question 6

Most common source of artery-to-artery embolic stroke is ?

A	Aortic arch
B	Carotid bifurcation
C	Common carotid
D	Vertebral arteries

Question 6 Explanation:

Carotid bifurcation atherosclerosis is the most common source of artery-to-artery embolus

Question 7

NASCET and ECST trials advocate carotid endarterectomy when carotid artery stenosis is more than ?

A	30 %
B	50 %
C	70 %
D	90 %

Question 7 Explanation:

North American Symptomatic Carotid Endarterectomy Trial (NASCET) & European Carotid Surgery Trial (ECST) showed benefit for carotid endarterectomy when stenosis of >70%.

Question 8

Carotid endarterectomy is most beneficial within how many weeks of symptom onset ?

A	2 weeks
B	4 weeks
C	6 weeks
D	8 weeks

Question 8 Explanation:

Carotid endarterectomy is most beneficial when performed within 2 weeks of symptom onset. Benefits more men than women and those >75 years.

Question 9

The underlying pathology in lacunar stroke is ?

A	Congenital anomaly
B	Embolism
C	Lipohyalinosis
D	All of the above

Question 9 Explanation:

Lipohyalinosis appears as an eosinophilic deposit in the connective tissue of the vessel wall.

Question 10

In lacunar infarction, what size of a small artery is occluded in brain ?

A	10 to 100 μm
B	20 to 200 μm
C	30 to 300 μm
D	40 to 400 μm

Question 10 Explanation:

Lacunar infarction refers to infarction following atherothrombotic or lipohyalinotic occlusion of a small artery (30 to 300 μm) in brain.

Question 11

“Lacune” in Latin means ?

A	Deficiet
B	Lake
C	River
D	Stone

Question 11 Explanation:

Lacunes in Latin mean “lake”. Clinicaly, lacunae are "small, deep cerebral infarcts".

Question 12

The principal risk factor for lacunar infarcts is ?

A	Hypertension
B	Diabetes mellitus
C	Cigarette smoking
D	Stress

Question 12 Explanation:

Hypertension and age are the principal risk factors for lacunar infarcts.

Question 13

Lacunar infarcts range in size from ?

A	1 mm to 5 mm
B	1 mm to 10 mm
C	2 mm to 10 mm
D	3 mm to 20 mm

Question 13 Explanation:

Lacunar infarcts range in size from 3 mm to 20 mm.

Question 14

Which of the following is not a lacunar syndrome ?

A	Pure motor hemiparesis due to infarct in posterior limb of the internal capsule
B	Pure sensory stroke due to infarct in ventrolateral thalamus
C	Ataxic hemiparesis due to infarct in base of pons
D	Dysarthria and clumsy hand due to infarction in medulla

Question 14 Explanation:

Lacunar syndrome dysarthria and a clumsy hand or arm due to infarction in the ventral pons or in the genu of the internal capsule.

Question 15

Which of the following increases risk of venous thrombosis and arterial thrombosis ?

A	Antiphospholipid syndrome
B	Systemic malignancy
C	Homocysteinemia
D	Factor V Leiden mutation

Question 15 Explanation:

Besides increasing risk of venous thrombosis, Protein S deficiency and homocysteinemia may cause arterial thromboses as well.

Question 16

Which of the following can be a cause of embolic stroke ?

A	Polycythemia vera
B	Libman-Sacks endocarditis
C	Nephrotic syndrome
D	Sickle cell anemia

Question 16 Explanation:

Systemic lupus erythematosus with Libman-Sacks endocarditis can be a cause of embolic stroke

Question 17

Cerebral veins contain how much of the total cerebral blood volume ?

A	30 %
B	50 %
C	70 %
D	90 %

Question 17 Explanation:

Cerebral veins contain 70% of the total cerebral blood volume.

Question 18

Veins that connect superior sagittal sinus with the scalp veins are called ?

A	Representative veins
B	Envoy veins
C	Emissary veins
D	Messenger veins

Question 18 Explanation:

Superior sagittal sinus (SSS) drains major part of the cortex. It also receives diploic veins, themselves connected to scalp veins by emissary veins, which explains the occurrence of SSS thrombosis after scalp infection or minor head trauma

Question 19

Lateral sinuses (LS) drain blood from which of the following ?

A	Cerebellum
B	Brainstem
C	Posterior part of cerebral hemispheres
D	All of the above

Question 19 Explanation:

The lateral sinuses (LS) drain blood from the cerebellum, brainstem, and posterior part of the cerebral hemispheres. They also receive some of the diploic veins and some small veins from the middle ear, another classic source of septic thrombosis.

Question 20

Which of the following is a feature of superficial cerebral veins or cortical veins ?

A	Thin walls
B	No muscle fibers
C	No valves
D	All of the above

Question 20 Explanation:

The superficial cerebral veins or cortical veins have thin walls, no muscle fibers, and no valves, thereby permitting both dilation & reversal of the direction of blood flow when the sinus into which they drain is occluded.

Question 21

Which of the following drain into cavernous sinuses ?

A	Superior and inferior ophthalmic veins
B	Sphenoparietal sinus
C	Middle cerebral vein
D	All of the above

Question 21 Explanation:

Cavernous sinuses drain the blood flow from the orbits through the superior & inferior ophthalmic veins, and from the anterior part of the base of brain by the sphenoparietal sinus and the middle cerebral vein.

Question 22

The cavernous sinuses empty into which of the following ?

A	Superior petrosal sinus
B	Straight sinus
C	Great vein of Galen
D	Superior sagittal sinus

Question 22 Explanation:

The cavernous sinuses empty into both the superior and the inferior petrosal sinuses and ultimately into the internal jugular veins.

Question 23

Thrombosis of which of the following venous sinuses mostly manifests as cranial nerve palsies ?

A	Petrosal sinuses
B	Straight sinus
C	Superior sagittal sinus
D	Transverse sinus

Question 23 Explanation:

Because of the close relationship of the petrosal sinuses to cranial nerves, thrombosis of petrosal sinuses (with or without thrombosis of transverse sinus) may produce cranial nerve palsies, especially cranial nerves III, V, VI, VII, and VIII. Thrombosis of the petrosal sinuses is characterized mainly by a fifth nerve palsy for the superior petrosal sinus and by a sixth nerve palsy for the inferior sinus.

Question 24

Which of the following statements about thrombosis of cerebral venous sinuses is false ?

A	In most patients, thrombosis occurs in > one sinus
B	Hypoplasia & atresia of transverse sinuses frequent
C	A prothrombotic risk factor or a direct cause is identified in ~85 % of patients
D	None of the above

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See all quizzes of Cerebrovascular Diseases Ischemic stroke at here:

Cerebrovascular Diseases Ischemic stroke- Part 1| Cerebrovascular Diseases Ischemic stroke- Part 2| Cerebrovascular Diseases Ischemic stroke- Part 3|Cerebrovascular Diseases Ischemic stroke- Part 4|Cerebrovascular Diseases Ischemic stroke- Part 5| Cerebrovascular Diseases Ischemic stroke- Part 6| Cerebrovascular Diseases Ischemic stroke- Part 7|Cerebrovascular Diseases Ischemic stroke- Part 8

1 In acute ischemic stroke, cerebral edema peaks on ?
A. Day 1
B. Day 2 – 3
C. Day 4 – 5
D. Day 5 – 6

2 The established dose of rtPA to be administered within 3 hours of
acute ischemic stroke is ?
A. 0.1 mg/kg
B. 0.3 mg/kg
C. 0.9 mg/kg
D. 1.2 mg/kg

3 The time of acute ischemic stroke onset is defined as ?
A. Time the patient’s symptoms began
B. Time the patient was last seen as normal
C. Time to bed in those who awaken with stroke
D. All of the above

4 Which of the following studied the value of thrombolytics via an
intraarterial route in acute ischemic stroke ?
A. PROACT II
B. ECASS
C. ATLANTIS
D. NINDS
5 In Chinese Acute Stroke Trial (CAST), dose of aspirin was ?
A. 75 mg/day
B. 160 mg/day
C. 300 mg/day
D. 625 mg/day

6 TOAST trial investigated which of the following in acute ischemic
stroke ?
A. Low-molecular-weight heparin
B. Unfractionated heparin
C. Aspirin
D. Glycoprotein IIb/IIIa

7 Neuroprotection is the concept related to ?
A. Preventing reinfarction
B. Prolonging brain’s tolerance to ischemia
C. Checking the risk factors
D. All of the above

8 Restraint therapy is best related to ?
A. Checking the risk factors
B. Checking the precipitating factors
C. Recruiting unused neural pathways
D. Avoiding psychological stress

9 Emboli in ‘Hollenhorst plaque’ are composed of ?
A. Cholesterol
B. Calcium
C. Platelet-fibrin debris
D. Bacteria

10 Todd’s paresis is related to ?
A. Seizure
B. Brain tumor
C. Migraine
D. Metabolic encephalopathy

11 Cerebral perfusion pressure (CPP) is defined as ?

A. Systolic blood pressure – intracranial pressure
B. Diastolic blood pressure – intracranial pressure
C. Mean arterial pressure – intracranial pressure
D. Mean arterial pressure (MAP) ÷ intracranial pressure

12 Which of the following is responsible for autoregulation of cerebral
blood flow ?
A. Stems of ACA, MCA, PCA
B. Circle of Willis
C. Microcirculation
D. All of the above

13 Cerebral blood flow is principally influenced by all except ?
A. Systemic blood pressure
B. pH
C. PCO2
D. PO2

14 Volume of CSF within ventricles and surrounding the brain and
spinal cord is about ?
A. 50 mL
B. 100 mL
C. 150 mL
D. 200 mL
15 Cerebral blood volume is about ?
A. 50 mL
B. 100 mL
C. 150 mL
D. 200 mL

16 “Histotoxic hypoxia” is produced by ?
A. Shock
B. Asphyxiation
C. Carbon monoxide poisoning
D. Any of the above

17 Selective persistent memory deficits after brief cardiac arrest is
due to injury to ?
A. Cerebral cortex
B. Basal ganglia
C. Hippocampus
D. Hypothalamus

18 Which of the following convey a poor prognosis after a severe
hypoxic-ischemic insult ?
A. Myoclonic status epilepticus
B. Absence of pupillary light reflex day 3 after injury
C. Bilateral absence of somatosensory evoked response
D. All of the above

19 What proportion of all ischemic strokes are due to cardioembolism ?
A. ~ 10 %
B. ~ 20 %
C. ~ 30 %
D. ~ 40 %

20 What proportion of all ischemic strokes are due to carotid
atherosclerosis ?
A. ~ 10 %
B. ~ 20 %
C. ~ 30 %
D. ~ 40 %

21 What proportion of all strokes are due to small-vessel disease ?
A. ~ 10 %
B. ~ 20 %
C. ~ 30 %
D. ~ 40 %

22 Sudden onset of neurologic dysfunction in embolic stroke is
usually maximum at ?
A. Onset
B. At 12 hours
C. At 24 hours
D. At 48 hours

23 Which of the following vessels is infrequently involved in
embolization from heart ?
A. Anterior cerebral artery (ACA)
B. Middle cerebral artery (MCA)
C. Posterior cerebral artery (PCA)
D. Branches of posterior cerebral artery

Cerebrovascular Diseases Ischemic stroke

[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 3

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Cerebrovascular Diseases Ischemic stroke- Part 3

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