Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Lucy Knox - Year 2 > 202 - Stroke > Flashcards

202 - Stroke Flashcards

1
Q

What is a stroke?

A

A neurological deficit related to an atraumatic vascular event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the key clinical features of a stroke?

A 
Focal deficit
Negative phenomena (loss of movement..)
Related to vascular anatomy
Sudden onset
Identifiable vascular risk factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do you expect to see on CT after an ischaemic stroke?

A

May look normal early on
Later - loss of grey-white matter differentiation
Hypo-density of area affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you expect to see on CT after hemorrhagic stroke?

A

Area affected lights up bright white early on, then turns more dense/dark in time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is used to make an ischaemic stroke light up in MRI?

A

Diffusion weighting scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What makes MRI better than CT in an acute stage of ischaemic stroke?

A

Ischaemia can be seen earlier

Subtle patholoigy seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What imaging modalities are used to image cerebral vessels?

A

USS of carotids
MRA / CTA
MRV /CTV
Catheter angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What treatment is used post stroke to reduce the consequences of it?

A

Thrombolysis

Rehab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is thrombolysis? When can it be used?

A

Clot busting - ONLY ISCHAEMIC STROKES
for blocked vessels
Use IV rTPA, only if <3hrs since onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a risk of doing thrombolysis?

A

There is a 6% risk of causing ICH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is targeted to reduce the risk or recurrence of a stroke?

A

Bp, Diabetes, smoking, weight, coagulability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

After a carotid embolic stroke, what blood thinning products are used long term?

A

Antiplatelets - ASA (aspirin) + clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

After a cardio-embolic stroke + CVST what blood thinning products are used long term?

A

Warfarin anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is surgery an option after a stroke to reduce reoccurrence?

A

Yes - vascular surgery - carotid endartectomy, stenting

But high risk!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What % of strokes are haemorrhagic?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What occurs in a haemorrhagic stroke?

A

A vessel in the brain bursts open and bleeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 3 main types of haemorrhagic stroke

A

PICH - Primary intracerebral haemorrhage
SAH - Sub arachnoid haemorrhage
CVST - Cerebral venous sinus thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the key features of a PICH?

A

Very acute
Headache
? LOC

  • Pt may have high Bp, be on anticoagulation therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why may you have LOC in a PICH?

A

Increased intracranial pressure - get cushings reflex - Bp auto reflex - heart pumps slowly, which causes pulse to drop and for the patient to feel faint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the key features of a SAH?

A

Sudden thunderclap headache
Meningism - photophobia, stiff neck
LOC
Wide spread of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the key features of a CVST

A 
DVT of brain - get secondary bleeding
Has no respect for arterial territories
Raised ICP
Can be subacute / evolving
Rare but devestating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the patient demographics for a CVST?

A

Younger patients, on the pill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the risk factors for a CVST?

A

infection, dehydration, malignancy, heart failure

24
Q

What % of strokes are ischaemic?

25
What happens in an ischaemic stroke?
A blocked vessel causes reduced availability of oxygen and nutrients to the area it supplies - signs depend on the location
26
What are the typical areas that an ischaemic stroke affect?
``` TAC - total anterior circulation LAC - Lacunar stroke PAC - Partial anterior circulation POC - Posterior circulation MCA - Middle cerebral artery ```
27
What blood vessels are affected in a TAC stroke?
Middle and anterior cerebral artery
28
What are lacunar vessels, affected in a lacunar stroke
Small perforating vessels - eg. in the internal capsule
29
What blood vessels are occluded in a POC stroke?
Basilar and vertebral
30
If a pt had a MCA in the L cerebral hemisphere, what signs might you see?
Acute R hemiparesis Dysphasia No LOC
31
What risk factors are there for ischaemic stokes?
``` hypertension AF (or other heart disease) Diabetes Hyperlipidaemia Smoking ... ```
32
What signs do you see in a brainstem stroke?
Ataxia - staggering, wide stance gait Diplopia Dysarthria Hemiparesis - crossed motor signs as neurones cross before the lower CN leave.
33
What is dysarthria?
Slurred speech
34
What is a TIA?
Transient Ischaemic Attack - Transient neurological episode Symptoms <24hrs Usually 10 mins
35
What is amarosis Fugax?
The feeling of the curtains coming down over your eyes
36
What does amarosis Fugax suggest?
TIA - Carotid circulation or anterior circulation issue
37
How do you calculate risk of something being a TIA?
``` ABCDD A ->60 B sBP >140, dBP >90 C Hemi-paresis and slurred speech D 60 bad news D Diabetes ```
38
How much of the resting cardiac output does the brain recieve?
20%
39
What is the brains blood flow in mls/100g/minute?
50 mls/100g/minute
40
How does the brain distribute its blood flow?
Varies according to metabolic rate | By cerebral perfusion pressure and tone of vessels
41
What occurs to the brain in profound hypotension?
Cerebral blood flow (CBF) inadequate - impaired metabolism - decrease in neuronal activity + neuronal loss.
42
What occurs to the brain in profound hypertension?
Hyperaemia causes cerebral oedema and hypertensive encephalopathy
43
What affects the autoregulation of the brain's blood flow?
Age, trauma, stroke, High pCO2
44
What is hypoxia?
O2 depravation
45
What is ischaemia?
Poor/impaired blood flow
46
Why do neurones get damaged with ischaemia?
They are obligate aerobes
47
How long until irreversible damage occurs to hypoxic neurones?
5-7 minutes without O2
48
What is global ischaemia int he brain?
Generalised reduction in perfusion | Due to: cardiac arrest, shock, severe low BP
49
What does global cerebral ischaemia cause?
Confusion focal deficits diffuse neuronal hypoxia
50
What external factors alter the effect of global cerebral ischaemia?
Degree + duration Temperature Blood glucose
51
What do ischaemic neurones look like (pathology)
Loss of organelles Loss of nucleus Pink cytoplasm Rarefied neutropil
52
Why is there a danger when the brain is reperfused after a stroke?
If reperfusion occurs too quickly it can cause damage due to the O2 free radicals that have been produced.
53
Which 3 arteries supply the brain?
Anterior cerebral Middle Cerebral Posterior Cerebral
54
What artery supplies the MCA and ACA?
The internal carotid
55
What artery supplies the PCA?
Vertebral - basilar - PCA

Lucy Knox - Year 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions