Baylor Flashcards
What stroke has the higher mortality - ischemic or hemorrhagic?
Hemorrhagic
What is the #1 Non-modifiable risk factor for stroke?
Age
What is the #1 MODIFIABLE risk factor for stroke?
Hypertension
Risk factor for stroke after TIA - use ABCD2 (what are the factors of this risk assessment tool?)
A - age (0-1) B - blood pressure (0-1) C - clinical features (weakness) (0-2) D - duration (0-2) D - h/o diabetes (0-1)
What disease do you suspect in a young patient without risk factors for CVA?
Anti-phospholipid syndrome
What is Virchow’s Triade? (clinical clues may be miscarriage, recurrent thrombosis, thrombocytopenia)
Hypercoagulable state Hemodynamic changes (stasis, turbulence) Endothelial injury
Medication to enhance motor recovery after stroke?
FLAME trial - Fluoxetine (PRozac)
What is CHADS2 risk assessment?
Atrial fibrillation risk for Stroke
C - CHF (1) H - hypertension (1) A - age > 75 (1) D - DM (1) S - h/o stroke (2)
What is Hypertension
BP > 130/90
Permissive hypertension after ischemic stroke? When to treat
Systolic > 220
Diastolic > 120
What is the increase in risk of stroke with history of Atrial Fibrillation?
5 TIMES!
What is Intra-cerebral hemorrhage due to?
Hypertension
-occurs when pt is calm
What is Subarachnoid hemorrhage due to?
Ruptured AVM
-occurs with strenuous activity / stress
What is Anton Syndrome?
- Lesion of bilateral PCA’s
- Cortical Blindness
- Denial of blindness
What is Balint Syndrome?
- Lesion of bilateral PCA’s but to the watershed region of occipito-parietal region
- Optic ataxia, apraxia and simultagnosia (inability to perecive more than one object at a time)
What is Alexia without Agraphia?
- Callosal branches of the PCA affecting splenium of Corpus Callosum
- Pure word blindness
What is the Rood Approach to stroke rehabilitation?
Sensory input used to facilitate movement
What is the Proprioceptive Neuromuscular Facilitation?
- Spiral and Diagonal movements
- Synergy patterns and facilitation
What is the Bobath approach to stroke rehabilitation?
-Isolating muscle control and inhibition of abnormal movements
What is Brunnstrom approach to stroke rehabilitation?
-Synergistic movements / functional movements
What is the most commonly used rehab approach for stroke?
Bobath approach
What strength is required for constraint induced therapy?
Wrist ext, thumb ext, finger ext
What is the gold standard to diagnose dysphagia after stroke?
Modified barium swallow
Medications that can be used for aphasia post-stroke?
Donepezil
Memantine
Donepezil - MOA and adverse effects
MOA - increases acetylcholine by binding to and inhibiting acectylcholinesterase
Adverse effects - nausea, diarrhea, vomitingf
Memantine - MOA and adverse effects
MOA - glutamatergic system NMDA receptor antagonist
Adverse effects - confusion, dizziness, drowsniness, HA, agitation, hallucination
