SCRN Anatomy, Physiology, and Pathophysiology of Stroke 5

Question 1

Which pathological process is responsible for the 'no-reflow' phenomenon seen after cerebral ischemia-reperfusion?

Accepted Answer

Microvascular obstruction by activated leukocytes, platelets, and edematous endothelium

Answer

No-reflow results from microvascular obstruction by adherent leukocytes and platelets, endothelial swelling, and perivascular edema preventing restoration of perfusion despite large vessel recanalization.

Question 2

A patient with a posterior cerebral artery stroke is most likely to present with which primary deficit?

Accepted Answer

Contralateral homonymous hemianopia

Answer

The PCA supplies the occipital lobe (primary visual cortex); PCA stroke classically causes contralateral homonymous hemianopia, often with macular sparing.

Question 3

Spreading cortical depolarization in stroke contributes to infarct expansion primarily by:

Accepted Answer

Repeatedly increasing metabolic demand in vulnerable penumbral tissue, expanding the infarct core

Answer

Peri-infarct spreading depolarizations repeatedly depolarize penumbral neurons, consuming limited energy reserves and progressively converting penumbra to infarct core.

Question 4

Which area of the internal capsule carries fibers controlling contralateral upper extremity movement?

Accepted Answer

Posterior limb (posterior one-third)

Answer

Corticospinal fibers controlling the contralateral arm travel in the posterior limb of the internal capsule; the face is at the genu and the leg is most posterior.

Question 5

In hemorrhagic stroke, perihematomal edema begins to develop most significantly at what time after the initial bleed?

Accepted Answer

24–72 hours

Answer

Perihematomal edema begins within hours but reaches its peak at 24–72 hours after ICH, driven by coagulation cascade activation, thrombin production, and BBB disruption.

(SCRN) Stroke Certified Registered Nurse Practice Test

(SCRN) Stroke Certified Registered Nurse Practice Test

SCRN Anatomy, Physiology, and Pathophysiology of Stroke 5