SCRN Exam Questions With Verified Answers Latest Updated 2024/2025 (GRADED)

SCRN Exam Questions With Verified Answers Latest Updated 2024/2025 (GRADED) Penumbra - Answer- Salvageable tissue -oxygen -blood pressure -Glucose Perfusion - Answer- What oxygen delivers to the brain. Above the necklace-Anterior Circulation= - Answer- Unilateral deficits Below the necklace-Posterior circulation= - Answer- Bilateral deficits Circle of Willis-Collateral circulation= - Answer- Aneurysm Cerebrum - Answer- largest part of the brain Cerebrum: Frontal Lobe - Answer- Motor function, personality, Brocca speech Brocca's aphasia-frontal lobe - Answer- problem with the production and grammar speech syntax, people know what they want to say but they cant produce the words. temporal lobe - Answer- Seizure, Wernicke speech, hearing Wernicke's aphasia (receptive aphasia)-temporal lobe - Answer- impaired auditory reception; speech may be fluent but is often meaningless or nonsensical parietal lobe - Answer- sensory input for touch and body position-neglect -teach patient to scan the room occipital lobe - Answer- vision basal ganglia - Answer- Hypertensive bleed Thalamus - Answer- sensory switchboard, located on top of the brainstem; -Patient waxing and waning -Patient asleep/awake -Thalamic pain syndrome thalamic pain syndrome - Answer- a condition caused by damage to the thalamus resulting in burning or tingling sensations and possibly hypersensitivity to things that would not normally be painful such as light touch or temperature change SCRN Exam Questions With Verified Answers Latest Updated 2024/2025 (GRADED) Cerebellum - Answer- Balance and coordination Left (Dominant) Hemisphere Stroke - Answer- -Left gaze preference (looks toward stroke area) -Right hononomous hemianopia -Right hemiparesis -Right hemisensory loss -Aphasia Right (Nondominant) Hemisphere Stroke - Answer- -Right gaze preference -Left hononomous hemianopia -Left hemiparesis, plegia -Left hemisensory loss *Neglect-left *Agnosia (failure to recognize objects) Posterior circulating stroke syndromes= - Answer- Wallenburg (Medulla) Horner's Syndrome Wallenberg syndrome - Answer- Nystagmus, Vertigo Horner's syndrome - Answer- ipsilateral ptosis miosis anhidrosis Ipsilateral - Answer- on the same side of the body Contralateral - Answer- on the opposite side of the body Miosis - Answer- constricted pupils anhidrosis - Answer- absence of sweating Locked-in syndrome - Answer- PONS How do you communicate with someone with locked-in syndrome? - Answer- Blinking eye movement Cerebral Venous Thrombosis - Answer- Hypercoagulopathy state Post-partum/PREGNANCY Carotid or Vertebral dissection-TRAUMA - Answer- Trauma most common cause TX: anticoagulation Arterio-venous Fistula - Answer- Ptosis-eyeball pops out Hears swishing Carotid Cavernous Fistula - Answer- Arterial venous connection between carotid artery and cavernous sinus---"the bulging red eye" -can be high-flow or low-flow -high flow results in patients with atherosclerosis and HTN with carotid aneurysms that rupture within sinus or secondary to closed head trauma (*basal skull fracture*) -S&S of high-flow: headache and confusion; *orbital bruit Carotid cavernous fistula (CCF) - Answer- Type A-High pressure Type B-Low pressure Type C-Low pressure Type D-Low pressure Moyamoya disease - Answer- "Puff of Smoke" Japanese, young female, genetic Small, thin walled torturous arteries Spontaneous stenosis, eventual occlusion TX: antiplatelet, CCB, surgery Moyamoya - Answer- Small, thin walled torturous arteries TX: surgery-re-establish blood flow to ischemic area SYNANGIOSIS- creation of new vessels Vasculitis- - Answer- Inflammation of blood vessels Answer: Steriod cavernous angioma - Answer- "less common than AVM. Similar to cavernous angioma elsewhere (liver). Formed by large irregular thin-walled vascular channels. Most are asymptomatic, may cause bleeding, epilepsy, or focal neuro problems" CT Scan=PURPLE LESION Dural arteriovenous fistula - Answer- Abnormal arteriovenous shunts that occur in the POSTERIOR DURA Usually acquired from trauma and associated with obstruction of venous sinus Stroke mimics - Answer- -Todd's Paralysis (postictal) -migraine with aura -Bell's Palsy -Hypoglycemia -MS -Hypertensive encephalopathy -Wernicke's -Central venous sinus thrombosus -ICH - SAH/SDH/EDH -Brain tumor -Conversion disorder -Meningitis/Encephalitis/Abscess TIA - Answer- transient ischemic attack....mini stroke, no dead tissue. Warning sign of potential or future stroke Symptoms resolve in minutes to hours No permanent neurological deficits Visual difficulties Carotid stenosis Carotid endarectomy Ischemic stroke - Answer- a type of stroke that occurs when the flow of blood to the brain is blocked Neuroplasticity - Answer- is remodeling process of the brain -creating new pathways via PT, OT, Speech -Neuroplasticity of penumbra is continuous repetition of the deficit-ROBOTIC repetition. Neuroplasticity & Stroke Recovery - Answer- Begins 1-3 days post stroke -Regains lost function after injury -Success of recovery depends on DESIRE of individual to gain functional ability The BE FAST acronym stands for: - Answer- Balance Eyes Face Arms Speech Time 7 D's of stroke care - Answer- Detection-Facial droop, arm weakness Dispatch-Ambulance gets PT Delivery-Pt deliver to ER Door-Pt arrives Data-CT scan Decision-Should tPA be given Drug-what drug Door to treatment Times - Answer- Door to ED physician exam=10 min Door to Stroke expertise=15 min Door to CT scan= 20 min Door to CT interpretation= 45 min Door to lab results= 45 min Door to Drug (rt-PA)= 60 min (2018: 45 min) A CT Scan without contrast can reveal what in the presence of headache? - AnswerBlood/Hemorrhage Blood is WHITE Ischemia/edema does not show up for 12-24 hours Brain parenchyma is gray Hypodensity on CT Scan - Answer- Hypo-Dark=Infarction Infarction-darker areas-occurs 12-24 hours post infarction Hyperdensity (on CT) - Answer- Hyper-White=Bleed/Hemorrhage Hyperdense MCA sign - Answer- White Line=Clot MCA Occlusion Large infarct Poor outcome Thrombectomy stent-like device to take out clot Blood on MRI - Answer- "Dead Chicken" Predicting ICH expansion - Answer- Sluggish White dot inside ICH Risk for rebleed Spot sign on CTA with contrast - Answer- White dot inside ICH-risk for rebleed Hunt & Hess grading system for SAH - Answer- 0-5 (prognosis good for 0-1; intermediate 3; poor 4-5) 0 - Unruptured 1 - Asymptomatic / headache 2 - mod-severe headache, nuchal rigidity, nothing focal 3 - decreased LOC, mind focal deficit 4 - stupor, hemiparesis 5 - coma, decerberate Hunt and Hess Classification and Prognosis - Answer- 0 Unruptured aneurysm 1 Asymptomatic or minimal HA/slight nuchal rigidity (30%) 2 Mod-severe HA; nuchal rigidity; no FND except CN palsy (40%) 3 ↓ LOC, confusion, or FND (50%) 4 Stupor; mod-severe hemiparesis (80%) 5 Deep coma; decerebrate posturing; moribund (90%) Hunt and Hess - Answer- assess for cerebral aneurysm CT perfusion - Answer- -angiography= full brain coverage (good for localization of clot), more radiation EMAIL ME: -perfusion= requires dedicated software, limited area of brain imaged, measures cerebral blood flow/blood volume; can identify "penumbra" CT Perfusion of the Brain - Answer- Tracks arterial blood in brain Indicates viable tissue Perfusion Maps: RED is DEAD GREEN is GO Significant mismatch=Green is greater than 20% of the red CT angiography (CTA) - Answer- Details blood vessel flow Large vessel occlusions Acute interventional treatment MRI (magnetic resonance imaging) - Answer- Obtain 24 hours after initial stroke Localizes stroke **Preferred test for brainstem or cerebellum stroke -bony artifact on CT Scan in posterior fossa MRI brain - Answer- Preferred test for brainstem or cerebellum stroke cerebral angiography - Answer- GOLD STANDARD for CEREBRAL VASCULATURE -Degree of stenosis -Detects 95% of aneurysm Provides Intervention -Thrombolytics -Thrombectomy -Angioplasty and stenting lumbar puncture (LP) - Answer- Spectrophotometry is preferred method-examine CSF lumbar puncture - Answer- Perform when clinical symptoms present and normal CT scan -Examine CSF for xanthochromia -present 6-12 hours after hemorrhage -SPECTROPHOTOMETRY preferred method -Visual inspection has good specificity Spectrophotometry - Answer- An analytical method for identifying a substance by its selective absorption of different wavelengths of light. transesophageal echocardiography (TEE) - Answer- PFO -combines ultrasound and endoscopy -Images posterior heart -clots, valves, PFO, LV function EMAIL ME: EEG - Answer- rule out seizure Lindegaard ratio - Answer- TCD=Vasospasm EKG - Answer- -Right hemisphere stroke -QTc prolongation -AFIB -Bundle Branch Block -PVC -Ischemic: Prolonged QT, U Wave -SAH: Deep T wave inversion -ICH: ST segment shift/T inversion Glasgow Coma Scale - Answer- Repeat until you get the best response Glascow - Answer- 8 or less intubate Glascow Coma Scale scoring - Answer- -Highest score is 15-Best responses! -lowest is 3 (deep coma or death) -Severe = GCS8 -Moderate = GCS 9-12 -Minor = GCS13 - Eyes: 4= open spontaneously 3= open to speech 2= open to pain 1= no opening - Verbal: 5= oriented 4= confused 3= inappropriate words/random 2= incomprehensible sounds 1= none - Motor: 6= obeys commands 5= localizes to pain 4= withdraws from pain (pulls away) 3= flex. in response to pain (decorticate) 2= ext. in response to pain (decerebrate) 1= no response NIHSS Stroke Scale - Answer- Measures Stroke Severity-locate Stroke location ****Does NOT measure gait