Clinical Stroke Info

Question 1

name 5 common cardiac causes of emboli strokes

Answer 1

a fib
prosthetic valves
MI 
endocarditis 
cardiomyopathy

Question 2

what are two most common associations with lacunar infarcts?

Answer 2

diabetes and HTN

Question 3

name a heme disorder that can lead to cerebral infarction?

Answer 3

sickle cell disease

Question 4

what is time frame for TIA?

Answer 4

10 minutes to 4hours

Question 5

what can you NOT have in TIA?

Answer 5

any infarction

Question 6

what are TIA patients at high risk for?

Answer 6

stroke duh

Question 7

what are vision changes seen in carotid ischemi?

Answer 7

transient monocular blindness ipsilateral

Question 8

what is motor change seen in caroti ischemia?

Answer 8

contralateral weakness and numbness of hand, arm, face

Question 9

can you have language deficit in carotid ischemia?

Answer 9

yes…if dominant hemi

Question 10

what are vision changes in vertebrobasilar ischemia?

Answer 10

dipoplia (double vision)

binocular graying/ loss of vision

Question 11

what is motor change invertebrobasilar ischemia?

Answer 11

unilateral or bilateral weakness/numbness in limbs

Question 12

what is cranial nerve change in vertebrobasilar ischemia?

Answer 12

dysphagia

Question 13

what is balance change in vertebrobasilar ischemia?

Answer 13

lack of balance…vertigo and staggering

Question 14

what is the clinical syndrome of lacunar infarcts to know?

Answer 14

pure motor lacunar infarct

Question 15

where does the pure motor lacunar infarct affect?

Answer 15

the internal capsule

Question 16

what portions of body are affected by pure motor lacunar infarct?

Answer 16

face arm and leg ipsilaterally

Question 17

what is a non contrast CT sensitive for?

Answer 17

hemorrhage is best seen with non contrast CT

Question 18

what drug given for acute stroke?

Answer 18

IV alteplase

Question 19

what is mechanism of alteplase?

Answer 19

binds fibrin and converst plasminogen into plasmin and plasmin then goes to break up clot

Question 20

what is SE with alteplase?

Answer 20

bleeding

Question 21

when should you never give IV alteplase?

Answer 21

if it is a hemorrhagic stroke!!

Question 22

if you cant do alteplase, what can you do to remove stroke clot?

Answer 22

thrombectomy

Question 23

what two drugs do we give for secondary stroke prevention?

Answer 23

aspirin and clopidogrel

Question 24

how long do patients take aspirin and clopidogrel?

Answer 24

21-90 days post event

Question 25

after 90 days of aspirin and clopidogrel, what do we switch to for stroke prevention?

Answer 25

warfarin or DOACs

Question 26

what are the DOACs for stroke prevention?

Answer 26

apixaban (Xa inhib)
rivaroxaban (Xa inhib)
dabigatran (direct thrombin inhib)
edoxaban (Xa inhib)