General Knowledge
Mgmt.
Deficits and Syndromes
Misc. and Movement
Rehab
Techniques
Techniques
100
What is the most important NON-MODIFIABLE risk factor for a stroke?
For a bonus 100 pts, what is the most important MODIFIABLE risk factor?
Age
HTN
100
The initial imaging modality of choice in patients presenting with stroke symptoms.
For a bonus 100 points, what color will an infarction be on a T2 MRI sequence?
Head CT without contrast
Infarction will be hyperintense (bright white) on T2 MRI (T2 = H20 = edema)
100
Locked-In Syndrome is secondary to an occlusion of the basilar artery causing tetraplegia with spared ability to move the eyes vertically and blink. What is spared in this stroke syndrome, causing the patient to be fully conscious?
Reticular Activating System (RAS)
100
In the Brunnstrom Stages of Stroke Recovery, when does spasticity peak?
Stage 3
100
"Use what you got" describes which type of rehab technique?
Brunnstrom Technique
200
The most common type of ischemic stroke is?
For a bonus 100 pts, what are the 3 types of ischemic stroke?
Thrombosis (thrombotic)
Embolic, Thrombotic, Lacunar
200
tPA should be considered in what type of stroke if the patient presents within what timeframe of onset of the stroke?
Ischemic, 4.5 hours
200
Which artery is most likely affected in Weber syndrome?
Posterior Cerebral Artery (PCA)
200
Aspiration typically occurs during which phase of swallowing?
Bonus 200 pts: What are the 4 phases of swallowing in order?
Pharyngeal Phase
Oral prep, oral phase, pharyngeal phase, esophageal phase
200
Use of cutaneous stimuli to enhance motor control and activity and reduce spasticity describes which rehab technique?
Rood Technique
"It's rood to touch someone"
300
What type of stroke has a higher acute mortality, but generally a more favorable functional prognosis if the patient survives the acute period?
Subarachnoid Hemorrhage
300
If a patient has had a SAH/ICH, which medication is utilized to prevent secondary vasospasm and what is the length of duration?
Nimodipine, 21 days
300
Do any of the brainstem stroke syndromes (Wallenberg, Weber, Medial Medullary, Locked-In) result in aphasia or cognitive deficits?
No
300
According to the International Dysphagia Diet Standardization Initiative (IDDSI), what level diet represents "pureed" for both liquid and solids?
Level 4
300
To attempt constraint-induced movement therapy (CIMT), patients must have...
Minimum of 10 degrees of wrist extension
400
The most common site of berry aneurysm rupture is the Anterior Communicating Artery, and another common site is the Posterior Communicating Artery. Rupture of a berry aneurysm at the PComm would affect which cranial nerve and cause what symptoms? (looking for three main sx)
CN3
Ptosis, down and out, blown (dilated) pupil aka mydriasis
400
Most stroke recovery occurs within:
A. 0-3 months
B. 3-6 months
C. 6-9 months
D. 9-12 months
B. 3-6 months
400
In Medial Medullary Syndrome, a patient will have tongue deviation toward the lesion, contralateral hemiparesis, and contralateral numbness. What tracts or nuclei are affected to cause these deficits?
CN12
Corticospinal Tract
Medial Leminiscus
400
Name two medications, other than Levodopa-Carbidopa, used to treat Parkinson's Disease.
Bonuse 200 pts: What is the acronym used to remember Parkinson's Disease? (must get the whole acronym correct)
Amantadine, Benztropine, MAO-B or COMT Inhibitors, DBS
TRAP (tremor, rigidity, akinesia, postural instability)
400
For 100 pts each:
What is the name of the therapy technique known for singing your speech?
How does it work?
What aphasia is it effective for?
Melodic Intonation Therapy
Recruits the right brain to help with speech
Broca's Aphasia
500
An intracerebral hemorrhage (ICH) is a type of hemorrhagic stroke due to HTN causing a vessel to burst. What is the most common site of an intracerebral hemorrhage?
Putamen
500
For 100 pts each:
Goal SBP in ischemic stroke?
Goal SBP in hemorrhagic stroke?
Goal ICP?
Goal CCP?
Bonuse 100 pts: CPP = ?
<220 mmHg
<180 mmHg
<20 mmHg
>60 mmHg (most important)
CCP = MAP - ICP
500
For 100 pts each: Name the four major symptoms of Wallenberg Syndrome and which one of the two arteries that is commonly involved.
“Dr. Horner Wallenberg at the VA says don’t PICA horse that can’t eat”
- Hoarse voice (CN9)
- Dysphagia (CN10)
- Ipsilateral Hornery Syndrome (ptosis, miosis, anhidrosis)
- May fall towards the lesion (PICA artery is cerebellar artery)
- Vertebral Artery and PICA
500
Huntington's Disease is caused by protein accumulation in which area of the brain and of which triplet repeat?
Bonus 100 pts: What is the phenomenon called where signs and symptoms of a genetic disorder become more severe and appear earlier in age in each successive generation?
Caudate Nucleus, CAG repeats
Anticipation
500
Name all 5 of the major stroke rehab techniques.
Bonus 100 pts each for brief and correct definitions of each.
Bobath: eliminate all primitive reflexes and flexor synergy patterns
Brunnstrom: Using spasticity and primitive synergy patterns after stroke to perform functional task
Rood: Use cutaneous stimuli to enhance motor control and activity, reduce spasticity
Proprioceptive neuromuscular facilitation (PNF): Challenge proproceptive abilities with DIAGONAL movements
Constraint-induced movement therapy (CIMT): Restrain the “good” arm and force the paretic arm to work