Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

951 Block 3 > 6. Stroke > Flashcards

6. Stroke Flashcards

1
Q

What is the FAST acronym?

A

F: face drooping
A: arm weakness
S: slurred speech
T: time - call 911 immediately

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

What is the most significant risk factor for stroke?

A

HTN

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

Uncontrolled HTN poses a __x greater risk of stroke than those without HTN.

A

5

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

Why does HTN increase the risk for stroke?

A
  • ↑ atherosclerosis

- weakens blood vessels in brain

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

What are the risk factors for stroke?

A
  • HTN
  • heart disease
  • DM
  • ↑ cholesterol
  • smoking
  • cocaine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 2 heart conditions especially increase risk of stroke?

A
  • atrial fibrillation

- myocardial infarction

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

Diabetics have __x the risk of stroke.

A

3

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

Why does ↑ cholesterol increase chance of stroke?

A

plaques can block blood vessels and contribute to the formation of blood clots

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

Smoking _____ the risk of ischemic stroke.

A

doubles

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

Why does cocaine use increase the risk of stroke?

A

causes cerebrovascular constriction and arrhythmias

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

What are the types of stroke?

A
  • ischemic
  • hemorrhagic
  • transiet ischemic attack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define ischemic stroke

A

Ischemic stroke occurs when an artery supplying the brain becomes obstructed.

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

What is the most common cause of ischemic stroke?

A

thrombi

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

What type of stroke is most common?

A

Ischemic (85%)

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

Ischemic stroke ultimately causes brain ________.

A

infarction

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

What are the 2 ways an ischemic stroke may occur?

A
  • thrombotic stroke

- embolic stroke

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

What is a thrombotic stroke?

A

Thrombus forms on atherosclerotic plaque and blocks blood flow in an artery suppling part of the brain.

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

What is an embolic stroke?

A

A clot forms in another part of the body (often heart) and migrates until it lodges in a brain artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a hemorrhagic stroke?

A

artery in the brain ruptures

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

Why does a hemorrhagic stroke cause ischemia?

A

disrupts blood supply downstream of hemorrhage

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

Aside from ischemia, what damage can a hemorrhagic stroke cause?

A
  • blood disrupts the chemical balance needed by neurons to function
  • vascular blood loss may increase pressure on surrounding brain tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In a healthy functioning brain, neurons never come in contact with whole blood. (T/F)

A

True

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

How do neurons receive oxygen and nutrients?

A

blood-brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In what ways can a hemorrhagic stroke occur?

A
  • bleeding aneurysm

- plaque-induced rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is an aneurysm?

A

a weakened segment of an artery that can stretch or balloon out under high pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What often causes aneurysms?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a plaque-induced rupture?

A

Artery walls that have lost elasticity and become brittle and thin can rupture.

28
Q

What is the common term for a TIA?

A

mini-stroke

29
Q

What causes TIA?

A

emboli that are then spontaneously dissolved by the fibrinolytic system, allowing re-established blood flow

30
Q

What is the average duration of a TIA?

A

a few minutes

31
Q

How are strokes diagnosed?

A

CT or MRI

32
Q

What is the most widely used imaging method for diagnosing stroke?

A

CT

33
Q

What is the unique diagnostic benefit of CT?

A

rule out hemorrhage

34
Q

MRI is sensitive to detection of _______.

A

ischemia

35
Q

What are the disadvantages of using MRI over CT?

A
  • takes longer to perform

- less widely available

36
Q

What is primary stroke prevention?

A
  • reducing risk factors

- ASA for those with evident atherosclerosis

37
Q

What is secondary stroke prevention after TIA?

A

Inhibiting platelet aggregation

  • ASA
  • Aggrenox
38
Q

ADP receptor antagonists are ineffective in preventing stroke. (T/F)

A

False: effective but $$$

39
Q

What ADP receptor antagonists are useful in preventing stroke?

A
  • clopidogrel
  • prasugrel
  • ticagrelor
40
Q

What is the treatment for acute ischemic stroke?

A

IV recombinant tissue-type plasminogen activator: alteplase (Activase)

41
Q

What is the only FDA approved thrombolytic agent for ischemic stroke?

A

alteplase

42
Q

When can alteplase be used to treat acute ischemic stroke?

A

within 3 hours of symptom onset

43
Q

What is the dose of alteplase when treating ischemic stroke?

A

0.9 mg/kg with 10% of dose given as bolus followed by 60 minute infusion

44
Q

What are contraindications of alteplase?

A
  • hemorrhagic stroke or head injury within 3 months
  • major surgery within 2 weeks
  • seizures at stroke onset
45
Q

When are anticoagulants indicated in ischemic stroke?

A

worsening symptoms

46
Q

What is the dose for heparin in ischemic stroke?

A
  • loading dose 50 - 100 U/kg

- continuous IV infusion to maintain aPTT 1.5-2.5 x normal

47
Q

In what patients would warfarin be used for stroke prophylaxis?

A

patients with a.fib or prosthetic heart valve

48
Q

What is the most common cause of cardioembolic stroke?

A

atrial fibrillation

49
Q

A recent study found aspirin to be superior to warfarin for stroke prevention in patients with atrial fibrillation and recent TIA. (T/F)

A

False: warfarin is superior to aspirin

50
Q

What agents can be used for secondary stroke prevention?

A
  • Aggrenox
  • Aspirin
  • ADP receptor antagonists
  • Direct thrombin/Xa inhibitors
51
Q

What is the dose of dabigatran for stroke prevention (non-valvular a.fib)?

A

150 mg BID

52
Q

What is the dose frequency for rivaroxaban for stroke prevention (non-valvular a.fib)?

A

single daily dose

53
Q

What is the dose frequency for apixaban for stroke prevention (non-valvular a.fib)?

A

BID

54
Q

What are the treatments for ischemic stroke that are currently under investigation?

A

Desmoteplase: thrombolytic agent
Ancrod: heparin alternative

55
Q

What is desmoteplase?

A

recombinant desmodus (vampire bat) salivary plasminogen activator

56
Q

How does desmoteplase compare to alteplase?

A
  • greater selectivity for fibrin bound plasminogen

- prolonged half-life

57
Q

What is ancrod (Viprinex) derived from?

A

venom of Malayan pit vipers

58
Q

What is the MOA of ancrod?

A
  • degrades fibrinogen in circulation
  • decreases blood viscosity
  • induces the release of endogenous t-PA from the vessel wall
59
Q

Why was ancrod development terminated?

A

increased risk of intracranial bleeding

60
Q

What is the only pharmacological treatment of hemorrhagic stroke?

A

nimodipine (Nimotop)

61
Q

What is nimodipine?

A

a CCB

62
Q

What is the route of administration of nimodipine?

A

oral

63
Q

Where does nimodipine have the greatest effect?

A

vascular smooth muscle of cerebral arteries as compared to peripheral arteries

64
Q

What chemical feature of nimodipine allows it to have good activity in brain?

A

highly lipophilic

65
Q

Why is nimodipine beneficial in strokes?

A
  • ↑ blood flow in ischemic brain areas

- ↓ neurological deficits caused by cerebral vasospasm following subarachnoid hemorrhage

951 Block 3 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions