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NEURO Exam 2 > CVA Pathophysiology > Flashcards

CVA Pathophysiology Flashcards

1
Q

What percentage of ACUTE stroke patients will have a recurrence?

A

25-35%

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2
Q

What is the percentage risk for recurrence within 5 years? And who is at higher risk?

A

40%

Men

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3
Q

Race and risk for stroke

_____>_____>_____

A

African Americans>Hispanic Americans>Caucasian

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4
Q

Identify 8 risk factors for stroke.

A

Hypertension, High serum cholesterol, Heavy alcohol use, obesity, smoking, cocaine use, diabetes mellitus, Heart disease

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5
Q

What are the 3 stroke classifications and which 2 are most common?

A

Thrombotic, embolic, and cerebral hemmorrhage

Thrombotic and embolic

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6
Q

What 2 things can cause a thrombotic CVA?

A

ASCHD and HTN

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7
Q

Other names for thrombotic CVAs?

A

“Stroke in progress”, mini stroke, transient ischemic attack.

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8
Q

What 3 things can a TIA indicate?

A

thrombolytic disease, possible vasospasm, and transient systemic arterial hypotension.

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9
Q

Medical management of thrombotic CVA and TIA includes:

A

Prevention, improving circulation ASAP, surgery ( thromboendarterectomy of the carotid or subclavian), pharmaceuticals (TPA under 3 hrs, anticoagulants, antiplatelets)

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10
Q

Embolic CVAs can orginate from _____, _____, and _____.

A

heart, internal carotid artery, carotid sinus

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11
Q

Which arteries are most commonly affect by embolic CVAs?

A

Branches of the MCA, poorer outcomes

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12
Q

Embolic CVAs are signs of ______.

A

Cardiac disease

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13
Q

Embolic CVA medical management includes: ____, ____, and _____.

A

Prevention, surgery, or long term anticoagulant therapy

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14
Q

3 possible causes of hemorrhagic stroke include:

A

HTN, ruptured saccular aneruysm (berry), and AV malformation (age 10-35 years most common)

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15
Q

What is a defining characteristic of a hemorrhagic stroke?

A

Displacement of midline structures

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16
Q

How long does it take to resorb blood from a hemorrhagic stroke?

A

6-8 months

17
Q

Medical management of hemorrhagic strokes include:

A

prevention and HTN management if it is caused by HTN
if it is a ruptured aneurysm, then surgery is indicated
Post surgery: HOB restrictions, 4-6 weeks of limited activity, and anti-seizure medication.

18
Q

Right side paralysis, speech and memory deficits, and cautious and slow behavior are indicative of a stroke on the ____ side of the brain.

A

Left

19
Q

Left side paralysis, perceptual and memory deficits, and quick and compulsive behaviors are indicative of a stroke on the ______ side of the brain.

A

Right

20
Q

Movement dysfunctions post CVA include:

A

decreased force production, decreased force regulation, abnormal synergistic movement, altered muscle contraction timing, decreased force regulation, delayed responses, abnormal tone

21
Q

Post CVA sensory dysfunctions include:

A

awareness, interpretation, any sensory modality, visual disturbances are common.

22
Q

Secondary impairments from CVA include:

A

changes in alignment, mobility, muscle and soft tissue length, pain and edema

23
Q

The ________ is stroke specific and should be used in the initial eval.

A

Orpington prognostic scale

24
Q

True/False: the OPS should be used for acute prognosis.

A

False. Should only be used when neurologically stable., Optimal predictive power at 2 weeks post stroke, scores range from 1.6-6.8.

25
Q

What range of scores on the OPS indicates moderate deficits?

A

3.2-5.2

26
Q

> 5.2 on the OPS indicates possible _____

A

dependent with increased liklihood of institutionalization

27
Q

Initial functional gains in recovery are attributed to:

A

reduced cerebral edema, absorption of damaged tissue, and improved vascualr flow. Followed by neuroplasticity.

28
Q

Motor function may take ______.

A

Years

29
Q

Initial UE movement return in first ____ weeks is predictive of full arm recovery.

A

2

30
Q

Failure to recover grip strength by _____ days is predictive of no UE recovery at ____ months.

A

24, 3

31
Q

What percentage of patients have no arm recovery?

A

30%

32
Q

How much functional recovery is predictable at 1 month?

A

86%

NEURO Exam 2 (3 decks)

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