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RMO Quiz

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									RMO Quiz 1.
                                                                Question 1.
     This 87-year-old woman was brought to
      the hospital after being found by her
      family to be disoriented. She has a history
      of atrial fibrillation and a left occipital
      stroke that occurred 6 years ago. She was                           C
      noted to have L face and arm weakness. A
      CT scan was performed.

a.   In addition to the clearly visible left occipital stroke
      there is:
                                                                              D
     an acute left MCA infarct
                                                           B
     an acute right MCA infarct

     an acute right PCA infarct

     nothing abnormal                         E
     Please label marked arrows.
     B-E.
                                                         Question 2.
   A 65 year old man attends following 30 min of L sided weakness. His wife describes a facial
    droop, slurred speech and a weak L arm and leg. Currently he looks and feels well, all signs
    having resolved. His BP is 160/90.



   a. What is this man’s risk of a stroke in the next 7 days?
   b. Should he be admitted?
   c. How would you assess this?
                                                  Question 3.
   This 43-year-old man was in his usual
    state of health at 1 am, but was found at 6
    am vomiting and seizing and rapidly
    becoming unresponsive. In the Emergency
    Department, he was noted to be markedly
    hypertensive. A CT scan was obtained.

   a. The scans demonstrate which of the
    following:

   loss of gray-white distinction and/or
    hypodensity
   ventricular enlargement
   hemorrhage
   a mass lesion
   an arteriovenous malformation
   nothing abnormal

   b-g. Name the types of brain bleeds you
    know.
                                                        Question 4.

   a-c. Name the 3 higher functions that allow you to easily and reliably determine that a stroke is
    cortical rather than subcortical.

   d. What is the pathological significance of this?
                                                Question 5.

   a-b. What are the predominant risk factors for subcortical strokes?



   c. Where are these often seen on CT scan?
                                                      Question 6.
   A 74 year old woman presents following an episode of LOC which lasted 30 seconds. She
    experienced no warning symptoms and when she came to she was alert and orientated although a
    little clammy. On examination there is no focal neurological abnormality.

   Why is this lady unlikely to have had a stroke?

								
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