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Dr. Petya Stefanova

Teacher

Assistant at the Faculty of Medicine at Sofia University and resident physician in Neurology at Sofiamed University Hospital.

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Case Steven Q13: When can the patient have his hip replacement surgery following an acute ischemic stroke and treatment with thrombolysis (tPA)?

Case Steven Q12: What is the appropriate secondary prophylaxis for this patient after an acute ischemic stroke?

Case Steven Q11: What actions should be avoided during the 24 hours following intravenous thrombolysis (tPA) administration?

Case Steven Q10: Thirty minutes after starting intravenous thrombolysis (tPA), the patient begins to lift his hand and shows improvement in his speech. What should be done at this stage?

Case Steven Q9: The patient, a 68-year-old male, presents with acute ischemic stroke symptoms that began 1 hour ago. His weight is 80 kg, and his height is 175 cm. His blood pressure is 185/90 mmHg, and his blood glucose level is 8 mmol/L. Based on these details, what is the correct dose of intravenous tissue plasminogen activator (tPA) to administer?

Case Steven Q8: The blood test results are normal, and the CT scan describes an ASPECTS score of 9, with a small hypodense zone in the left parietal lobe near the cortex, corresponding to the patient’s symptoms of right-sided weakness and slurred speech. What is the next step in the treatment choice?

Case Steven Q7: What tests should be ordered for this patient with acute onset right-sided weakness and slurred speech?

Case Steven Q6: For the patient’s symptoms of acute onset right-sided weakness (severe for the hand and mild for the leg) and slurred speech, what is the NIHSS score?

Case Steven Q5: The nurse reports the following parameters: blood pressure 185/90 mmHg, heart rate 80/min, sinus rhythm on ECG, blood oxygenation 91%, and blood glucose 8 mmol/L. Does any of these parameters require correction at this time?

Case Steven Q4: The patient is taking metformin, antihypertensive medications and immunotherapy for psoriasis. Is any of these drugs a contraindication for thrombolysis?

Case Steven Q3: Patient’s wife shares that symptoms started 1 hour ago. Patient is having type 2 diabetes, arterial hypertension, history of hepatitis B, glaucoma, mild hearing impairment, psoriasis, coxarthrosis, diabetic polyneuropathy, high cholesterol in his blood tests last year, COPD and he is smoking. Which of the following are risk factors for a cerebrovascular accident (stroke) in this patient?

Case Steven Q2: While the nurse checks the patient’s vital signs, what key questions will you ask the wife to gather essential information about the patient’s medical history and the event?

Case Steven Q1: It’s a typical busy Saturday afternoon in the emergency department when a 68-year-old male patient is brought in by his wife. The patient presents with a history of acute onset right-sided weakness, which is severe in his hand and mild in his leg. He also has slurred speech, which started one hour ago while he was having lunch with his family. You are the doctor who must assess the patient promptly. What are your first steps in assessing this patient?

Which nerve is responsible for the sneezing reflex?

What is the physiological response of the ANS during the “fight or flight” response?

Which cranial nerve is involved in parasympathetic innervation of the heart?

What is the role of the parasympathetic nervous system during rest and digestion?

Which neurotransmitter is primarily associated with the sympathetic nervous system?

What does the ANS usually operate without?

What are the two divisions of the motor portion of the ANS?

Neurotransmission

Parkinson’s Disease Differential Diagnosis Questionnaire

Role of the Direct and Indirect Pathways in the Extrapyramidal System: Balancing Motor Control

The Unified Parkinson’s Disease Rating Scale (UPDRS)

Lewy Body Dementia with Parkinsonism versus Parkinson’s Disease

Aging as a Risk Factor for Parkinson’s Disease

The Role of Genetics in Parkinson’s Disease

Protective Factors for Parkinson’s Disease: Physical Activity, Smoking, and Caffeine

Alpha-Synuclein vs. Tau Protein: A Comparative Overview

Alpha-Synuclein and α-Synucleinopathies

Genetics and Multiple Sclerosis

Etiology of Multiple Sclerosis

Differential Diagnosis for Parkinson’s Disease

Cauda Equina Syndrome (CES)

Treatment Options for Multiple Sclerosis

Diet Recommendations for Patients with Multiple Sclerosis

Wallenberg Syndrome (Lateral Medullary Syndrome)

Ischemic Stroke

How to Put on Sterile Gloves and Stay Sterile

Q 2.35. Emergencies in Neurology

Q 2.34. Dementia

Q 2.33. Headache

Q 2.32. Wilson’s Disease

Q 2.31. Chorea

Q 2.30. Progressive Muscular Dystrophy

Q 2.29. Spinal Muscular Atrophy

Q 2.28. Amyotrophic Lateral Sclerosis

Q 2.27. Parkinson’s Disease

Q 2.26. Status Epilepticus

Q 2.25. Epilepsy

Q 2.24. Traumatic Brain Injury

Q 2.23. Spinal Cord Tumors

Q 2.22. Cerebral Tumors

Q 2.21. Cerebral Vein and Dural Thrombosis

Q 2.20. Subarachnoid Haemorrhage

Q 2.19. Parenchymal Brain Haemorrhage

Q 2.18. Part 2 Cerebral Infarction – Diagnosis and Differential Diagnosis

Q 2.18. Part 1 Cerebral Infarction – Types and Warning Signs

Q 2.17. Asymptomatic Cerebrovascular Disease. Transient Ischemic Attacks.