SCRN Study Guide Questions with Complete
Answers.
A 67yo man with a hex of HTN, DM, HLD, and smoking presents to the ED. CC of
persistent dizziness q1week that has become so severe he now has double vision, N/V.
His wife tells you she noticed a L facial droop and slurring. Pt reports weakness in L arm
and leg. He denies HA or SZ. Head CT was negative for acute bleed. Upon returning to
the room he has become increasingly obtunded and difficult to arouse. You notice he
now has a nystagmus and slightly dysconjugate gaze. His exam appears to be
worsening now with R/L extremity weakness in addition to his L hemiparesis. What type
of stroke syndrome are you concerned he may be having?
a. Wallenberg's stroke
b. Dissection of the R internal carotid artery
c. acute basilar artery occlusion
d. Superior cerebellar artery stroke - ANS c
You are assessing a 35yo M who has been in a motor vehicle crash, and during the
exam you notice he has some abnormal eye exam findings and weakness in the R arm
and leg (arm more than leg). He has droopiness of the L eyelid and his pupils are
unequal. The L pupil is 3mm in diameter and the right is 5MM. Both pupils are round
and reactive to light. Although it is a hot, humid day, he is not sweating from the heat.
What stroke syndrome do you suspect your patient is experiencing?
a. Weber's syndrome
b. Amaurosis fugax
c. Locked-in syndrome
d. Horner's syndrome - ANS d
What is a possible cause of Horner's syndrome?
a. Occlusion of the MCA
b. Dissection of the L ICA
c. Dissection of the R ICA
d. ACA stroke - ANS b
a patient presents with central retinal artery occlusion. As you evaluate the
neuroimaging, you recognize that the most likely etiology is artery-to-thrombosis from
which artery?
a. Basilar artery
b. Middle cerebral artery
c. Posterior inferior cerebellar artery
d. Carotid artery - ANS d
, A patient is admitted to the emergency department with acute symptoms of
hemiparesis, hemi-sensory loss, gaze preference, and aphasia. Which vessel do you
suspect is involved in the stroke?
a. ACA
b. MCA
c. PCA
d. PICA - ANS b
What cluster of symptoms is consistent with Weber's syndrome?
a. Ipsilateral cranial nerve 3 palsy, contralateral hemiparesis
b. Ipsilateral cranial nerve 4 and 6 palsy, contralateral hemiparesis
c. Contralateral cranial nerve 4 and 6 palsy, ipsilateral hemiparesis
d. ipsilateral cranial nerve 5 paly, ipsilateral ataxia - ANS a
a patient is admitted with symptoms consistent with Weber's syndrome. If the stroke is
ischemic, which arteries would you suspect might have caused the stroke?
a. Carotid artery
b. Middle cerebral artery
c. Posterior cerebral artery
d. Basilar artery - ANS c
A patient presents with vertical gaze palsy, pupils mid-dilated with light dissociation, and
convergence-retraction nystagmus. This cluster of symptoms is consistent with which of
the following symptoms?
a. Weber's syndrome
b. Horner's syndrome
c. Parinaud's syndrome
d. Wallenberg's syndrome - ANS c
Parinaud's syndrome results from which part of the brain?
a. Dorsal midbrain
b. Lateral medulla
c. Ventral pons
d. Posterior inferior cerebellum - ANS a
You are caring for a pt who has had multiple small strokes in the watershed territory
between the ACA and MCA. Which of the following is the most likely etiology for this
type of stroke?
a. Embolus of cardiac origin
b. Carotid artery atherosclerosis
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