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Post Midterm Patho > CVA > Flashcards

CVA Flashcards

1
Q

What is a Cerebrovascular Disease? CVA

A

Stroke

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2
Q

Define what a CVA is. What is it? What is it due to?

A

an acute neurological deficit d/t ischemia

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3
Q

If a CVA is an acute neurological deficit d/t ischemia, what does this mean in regards to perfusion to the brain?

A

Lack of perfusion to the brain.

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4
Q

There are 2 Types of CVAs. Name them and explain what it is.
1.
2.

A
  1. Ischemic CVA
    - obstructed or occluded vessel causing lack of perfusion to the brain tissue
  2. Hemorrhagic CVA
    - vessel severed in cranium –> hemorrhage –> brain compression
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5
Q

Ischemic CVA: the vessel can be occluded why? (2)

A
  1. Embolus

2. Thrombosis

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6
Q

The risks for CVA

  1. Modifiable (5)
  2. Unmodifiable (4)
A
  1. HTN, atherosclerosis, Hyperlipiedmia, DM, Smoking

2. Aging, males, prior strokes, familial history

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7
Q

If the modifiable risk factors for CVA are managed, can a stroke be avoided?

A

Yes

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8
Q

The patho for CVA involves the brain being sensitive to what two things?
Can the brain utilize anarerobic metabolism?

A

Oxygen and glucose

The brain relies on aerobic metabolism for ATP

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9
Q

What are the two forms of stroke?

A
  1. Ischemic CVA

2. Hemorrhagic CVA

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10
Q

Explain the patho for Ischemic CVA:

A

Occlusion of the vessel –> focal ischemia –> necrotic core (dead tissue which will have loss of function) –> pneumbra around the necrotic core (tissue that is lacking perfusion but still alive) –> penumbra will become smaller and necrotic core bigger if there is not an intervention to increase the blood supply to the brain

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11
Q

What does focal ischemia mean?

What does global ischemia mean?

A

1 hemisphere affected

Most of the brain is obstructed (BIG PROBLEM!)

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12
Q
  1. Explain the patho for Hemorrhagic CVA:
  2. What usually causes this? (4)
  3. What are the two complications from this?
A
  1. severed vessel –> hemorrhaging –> compression
  2. Htn and ageing (also aneurysms and tumors)
  3. Coma and death
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13
Q

Define TIA

is this a large or mini stroke?

A

Transient Ischemic Attack

Mini stroke

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14
Q

Transient Ischemic Attack: what is occuring to the neurological deficit? d/t what?

A

acute, brief, neurological deficit d/t acute focal ischemia

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15
Q
  1. Is a TIA reversible?
  2. Is the ET/Patho of TIA similar to CVA?
  3. Does a TIA involve a necrotic core? Penumbra?
A
  1. Yes
  2. yes
  3. No nectrotic core, yes penumbra
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16
Q

Why would a TIA have a pneumbra?

A

The tissue is not being properly perfused, but there is no necrosis occuring.

17
Q

Does a TIA involve permanant damage?

A

No.

18
Q

If you have a TIA, what does this do for your risk of future TIA’s or strokes?

A

Increases the risk

19
Q

The manifestations for CVA depend on what?

Are the mnfts an acute onset?

A

the location, size of vessel, and area of brain distal to the vessel

Yes they are an acute onset

20
Q

The mnfts for a CVA in the left hempishere would present in the right side of a patient. Why?

A

D/t to the decaustation of the pyramids, the fibers cross over.

21
Q

What are the 3 main symptoms of a CVA?

A
  1. Unilateral weakness or numbness in face, arm, and or leg (1 or more)
  2. Speech alteration
  3. Altered vision in 1 eye
22
Q

How is CVA Dx (3)

A
  1. Labs
  2. EEG
  3. MRI/CT scans
23
Q

What labs are looked at for CVA? (3)

Expla

A

CBC, INR, lipids

24
Q
  1. Why assess the INR?

2. Why assess the lipids?

A
  1. Clotting time (for TPA)

2. Hyperlipedima can lead to atherosclerosis

25
Q

What is the electroencephogram looking at?

A

Conductivity of the brain tissue

26
Q

What is the MRI/CT scan looking for?

A

Differentiating between Ischemic and Hemorrhagic stroke

27
Q

The treatment for strokes main focus is to preserve AND salvage what?

A

Life! Penumbra!

28
Q

What is the Stat treatment for Ischemic stroke.

A

ASA (antiplatelet) 160 mg, then taper down

29
Q

What is the purpose of administering the antiplatelet?

A

Not allowing platelets to aggregate

30
Q

When would TPA be given to a patient?

A

When they meet the criteria and it is an ischemic stroke.

31
Q

The treatment for CV risk factors includes what? (2)

A

statins to decrease cholesterol

antihypertensives to decrease BP

32
Q

Sx for stenosis for patients with ischemic stroke. What is this procedure called? what is the time frame post stroke for it to be done?

A

Carotid endoarterectomy done within 2 weeks of CVA

33
Q

What would the stenosis be?

A

Narrowing of the blood vessel d/t atherosclerosis

34
Q

To prevent recurrence involves what? (2)

A

Reducing risk factors

Blood thinners to prevent thrombus reappearing

35
Q

Would a blood thinner ever be given to a patient experiencing a hemorrhagic stroke?

A

Nope you crazy lady.

36
Q

To prevent extension involves what?

A

preventing complications, be aware of aspirations

Post Midterm Patho (16 decks)

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