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Clinical 4th Year > Chapter 4- Stroke > Flashcards

Chapter 4- Stroke Flashcards

1
Q

What is stroke

A

A syndrome of rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting 24hrs or longer or leading to death with no apparent cause other than of vascular origin

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2
Q

What is TIA

A

Transient ischaemic attack- same as stroke but lasts less than 24hours

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3
Q

Why is a CT scan needed on admission for someone with suspected stroke

A

Distinguish between haemorrhagic and ischaemic stroke

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4
Q

Two types of stroke?

A

Ischaemic

Haemorrhagic

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5
Q

What causes ischaemic stroke

A

Atherosclerosis plaques rupture, form embolus/thrombus and travel to brain as block blood supply

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6
Q

What causes haemorrhagic stroke

A

Rupture bleed on brain

From aneurysm

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7
Q

Strategies for preventing stroke

A 
Reduce BP 
Reduce cholesterol 
Stop smoking 
Diabetes control 
AF identification
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8
Q

What does the ABCD score predict and what does it stand for

A 
Predicts risk of stroke after TIA
A= age >60 
B= BP SBP>140 or DBP>90
C=clinical features: 
-unilateral weakness (2)
-speech disturbances without weakness (1) 
D= duration of symptoms:
->60mins (2) 
-10-59 mins (1) 
-<10 mins (0) 
 diabetes= 1 point
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9
Q

What anticoagulation would you offer a patient with AF

A

Warfarin
Apixaban
Dabigatran
Rivaroxaban

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10
Q

When should you offer anticoagulation in patient with AF

A

CHA2DS2VASc score >2 or > 1 in males

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11
Q

What’s the dietary advice for primary prevention of stroke

A 
Total fat intake <30% 
Sat fat <7% 
Cholesterol <300mg/day
5portion fruit and veg 
2 portions oily fish /week 
4-5 portions of unsalted nuts, seeds and legumes per week
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12
Q

Recommendation for physical activity in primary prevention of stroke

A

150mins moderate intensity aerobic activity per week

75 mins

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13
Q

What is the CHADVASc score

A

Scoring system used to calculate the risk of a patient with AF having a stroke

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14
Q

What does CHA2DA2VASc score stand for and what’s the points

A 
C= CHF (1) 
H=hypertension (1)
A= age (>75=2) 
D= diabetes (1) 
S= stroke/TIA history (2) 
V=vascular disease (1) 
A= age (65-74=1) 
S= sex (female=1)
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15
Q

When do you offer rate or rhythm control in AF

A

Rate is first line except in people:

  • whose AF is reversible
  • heart failure due to AF
  • new onset AF
  • with atrial flutter suitable for ablation strategy
  • rhythm control more suitable
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16
Q

When do you offer rhythm control in AF?

A

When AF symptoms continue after heart rate has been controlled or for whom rate-control strategy has not been successful

17
Q

List symptoms of AF

A 
Palpitations 
Dyspnea
Chest pain 
Light headedness
Syncope 
Fatigue 
Thromboembolism 
Death

Clinical 4th Year (9 decks)

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