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Y3 Neurology > Cerebrovascular incl stroke > Flashcards

Cerebrovascular incl stroke Flashcards

1
Q

what congenital heart defect is a risk factor for stroke

A

patent foramen ovale

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2
Q

what is the definition of a stroke

A

focal/global loss of brain function lasting longer than 24hours

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3
Q

what feature distinguishes stroke and TIA

A

TIA lasts less than 24hr

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4
Q

what are the 2 main categories of stroke

A

infract/ischaemic and haemorrhagic

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5
Q

what is the commonest type of stroke? (85%)

A

infarct

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6
Q

what pathological finding is found on histology in strokes indicating acute neuronal injury (non-specific)

A

red neurons

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7
Q

ischaemic strokes are further split into categories based on their cause, name these

A

cardioembolic
atheroembolic/thrombotic
small vessel disease

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8
Q

what type of ischaemic stroke causes a fibrin dependent red thrombus and leukoariaosis

A

cardioembolic

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9
Q

what type of ischaemic stroke cause a platelet dependent white thrombus

A

atheroembolic

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10
Q

what is one of the most common sites of atheroembolic strokes

A

internal carotid bifurcation

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11
Q

arteriosclerosis, microaneurysms, vasculitis and amyloidopathies cause what type of ischaemic stroke

A

small vessel disease

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12
Q

what is the major risk factor for cardioembolic stroke

A

atrial fibrillation

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13
Q

where does the thrombus form in cardioembolic strokes

A

left ventricle

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14
Q

rheumatic heart disease and prosthetic valves are associated with what type of ischaemic stroke

A

cardioembolic

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15
Q

does hypertension cause a primary or secondary haemorrhagic stroke

A

primary

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16
Q

do AV malformations cause a primary or secondary haemorrhagic stroke

A

secondary

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17
Q

do aneurysms cause a primary of secondary haemorrhagic stroke

A

secondary

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18
Q

arteriosclerotic small vessel disease is most associated with which intracranial blood vessel

A

middle cerebral artery

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19
Q

5% of strokes are due to what type of intracranial haemorrhage?

A

SAH

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20
Q

what is the watershed area?

A

where the territory of 2 arteries meet (less well perfused)

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21
Q

what is the main cause of wedge infarcts in the watershed area?

A

hypovolaemic shock

22
Q

what is the commonest visual field defect cause by a stroke

A

homonymous hemianopia

23
Q

how would a stroke of the middle cerebral artery present

A

contralateral face & arm weakness.

dominant side: receptive/expressive dysphagia

24
Q

how would a stroke of the anterior cerebral artery present

A

contralateral leg weakness + sensory loss

25
Q

how would a vertebrobasilar stroke present

A

vertigo, ataxia, dysarthria, dysphasia

26
Q

DON’T FORGET TO LOOK UP IMAGES OF SCANS FOR HOW TO IDENTIFY HAEMORRHAGIC AND ISCHAEMIC STROKES!!

A

DO IT

27
Q

investigations for a ptx presenting with stroke like symptoms

A 
CT
ECG
carotid US
FBC
CRP
BP
BG
lipids
28
Q

if a carotid US is +ve when investigating stroke, what test should you do next?

A

carotid angiogram

29
Q

what test should you do if you suspect a patent foramen ovale?

A

bubble echo

30
Q

when investigating stroke, if someone has had symptoms for more than 10 days what imaging modality should you do

A

MRI not CT

31
Q

would an MCA infarct stroke appear hyper or hypodense

A

hyperdense

32
Q

anterior circulation syndrome can affect which arteries?

A

anterior cerebral or middle cerebral arteries (both originate from IC)

33
Q

how is anterior circulation syndrome categorised?

A

TACS total or PACS partial

34
Q

TACS is 3/3 and PACS is 2/3 of what signs

A
  1. homonymous hemianopia
  2. cortical sign e.g. dysphagia, neglect
  3. ipsilateral motor loss of two of face/arm/leg (+- sensory)
35
Q

lacunary syndrome is due to small deep infarcts, these often effect what type of blood vessel supplying what region of the brain?

A

penetrating artery

basal ganglia

36
Q

how does lacunar syndrome present

A

pure motor deficit to 2 of face/arm/leg
OR
pure hemisensory

37
Q

an isolated homonymous hemianopia is due to what type of stroke

A

POCS

38
Q

a bilateral motor/sensory deficit is due to what type of stroke

A

POCS

39
Q

cortical blindness is due to what type of stroke

A

POCS

40
Q

what type of stroke is a cerebellar stroke?

A

POCS

41
Q

locked in syndrome is due to a POCS stroke of what region of the brain

A

pons

42
Q

management of an ischaemic stroke

A

thrombolysis if <4.5hours.

if over; antiplatelet aspirin

43
Q

what are the 2 methods of thrombolysis

A

IV tPA or EVT

44
Q

side effects of thrombolysis

A

bleeding eg. intracranial, stomach ulcer, veneflon site

45
Q

long term management of an ischaemic stroke

A

after 2 weeks of aspirin, begin long term clopidogrel

46
Q

what is the method of DVT prevention in stroke

A

intermittent pneumatic compression

47
Q

for patients with AF, following a stroke, what medication should you switch aspirin to?

A

edoxaban

48
Q

what drugs are options for HTN Mx post stroke

A

perindopril
indapamide
amlodipine

49
Q

management of patent foramen ovale to prevent stroke risk

A

long term aspirin

50
Q

management of carotid stenosis

A

carotid endarterectomy

51
Q

what is one of the differentiating factors in the presentation of vascular dementia and alzeihmer’s? (excluding history of CVD)

A

vascular dementia has a more abrupt onset

52
Q

what condition are charcot-bouchard microaneurysms associated with

A

long standing HTN

Y3 Neurology (23 decks)

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