Stroke & Cerebrovascular Disease

1.A 50 years old male who is a chronic alcoholic and smoker, on irregular medications for diabetes was brought to the casualty at

• a) 30 am with history of sudden onset unresponsiveness since morning
• b) 00 am. On examination patient is drowsy with facial deviation to left side, paucity of movement of right side body, with exaggerated deep tendon reflexes and extensor plantar on the same side: BP: 170/120 mm/Hg
• c) What is your anatomical and etiological diagnosis
• d) What are the modifiable and nonmodifiable risk factors
• e) What are the relevant investigations to be done
• f) How do you manage the above patient
• g) Define TIA and explain the significance of TIA in the above case scenario.”

2.Streptococcus pneumonia

• a) Neisseria meningitides
• b) E coli
• c) Proteus
• d) 1 & 2 are correct
• e) 1 & 3 are correct
• f) 3 & 4 are correct
• g) 2 & 4 are correct
• h) Follow up drugs used in acute ischemic stroke to prevent the recurrence of stroke in future are
• i) Aspirin
• j) Naproxen
• k) Statins
• l) Corticosteroids
• m) 1 & 2 are correct
• n) 1 & 3 are correct
• o) 3 & 4 are correct
• p) 2 & 4 are correct
• q) The thrombolysis is done in

3.A 60-year-old man is diagnosed to have right hemiplegia due to thrombotic stroke

• a) Define stroke
• b) What are the expected physical signs in this patient
• c) What are the causes for this condition
• d) What are the investigations needed to confirm the diagnosis
• e) What are the treatment modalities for this condition

4.A 45-year-old man c/o sudden weakness of the right upper and lower limbs with visual problems and slurring of speech since one day. Next day he walked into OPD for evaluation with no residual neurological defects.

• a) What is the most probable clinical diagnosis
• b) Enumerate the risk factors
• c) Write the investigations to be done on this patient
• d) Discuss the management of this condition

5.50 years old man with history of type 2 diabetes mellitus and primary hypertension presented with sudden onset weakness right half of the body and alteration of sensorium. He reported within 2 hours of onset. Answer the following:  What is your probable diagnosis  What investigations will you do on admission  How will you manage this patient  What are the complications

6.A 70 years old male having hyperlipidemia presents with inability to move his left hand and leg for one day duration. He felt that his left hand was weak in the morning and in the evening he developed weakness of left leg. On examination vitals signs were stable. No wasting of muscles, spasticity of the left upper and lower limb. Power grade IV on the left side. Brisk deep tendon reflex on the left side and up going plantar on the left side. Other systems were normal. Answer the following: • What is your probable diagnosis. • Where is the lesion. • How will you confirm the diagnosis. • How will you treat this condition

1.Management of acute ischemic stroke

2.Two causes of subarachnoid hemorrhage

3.Contraindications for thrombolysis in acute ischemic stroke

4.Crossed hemiplegia

5.Imaging in acute stroke