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Year 2 neuro exam 2 > CVA TIA, Pales I > Flashcards

CVA TIA, Pales I Flashcards

1
Q

incidence of strokes

A

1 every 40 seconds

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2
Q

leading cause long-term disability in US

A

stroke

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3
Q

CVA

A

cerbro vascular accident

abrupt onset neuro deficit that is attributable to focal vascular cause

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4
Q

2 major types of stroke

A

hemorrhagic stroke

ischemic stroke

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5
Q

What is the penumbra in ischemia

A

brain tissue around cerebral necrosis that has reversible changes

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6
Q

main categories of causes of ischemic strokes

A

large artery thrombosis
embolism
lacunar

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7
Q

what are the originations of embolisms that can cause ischemic strokes

A

arterial: carotid or aorta
heart: atrial, valve or ventricular
paradoxical

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8
Q

what are the not common causes of stroke

A 
watershed infarcts
hypercoagulable disorders
vasculitis
vasospasm
dissection of artery
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9
Q

what happens in large artery thrombosis

A

activate platelets and coagulation that cause occlusion

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10
Q

types of emboli that cause strokes

A

athersclerotic plaques and those from thrombi

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11
Q

source for paradoxical emboli

A

lower extremity DVT

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12
Q

atrial source of emboli

A

a fib, flutter
atrial septal aneurism
atrial tumors (myxoma)

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13
Q

what is afib

A

fast and ineffective atrial contraction leading to stasis and thrombus formation

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14
Q

atrial septal aneurysm

A

weakening and out-pouching of interatrial septum leading to stasis and thrombus formation (mural)

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15
Q

most common tumor in atrium

A

atrial myxoma

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16
Q

atrial myxoma

A

pieces of tumor may tear off and become emboli

associated thrombus can embolize artery down the stream

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17
Q

emboli from ventricular source

A

cardiomyopathy
myocardial infarction
ventricular aneurisms

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18
Q

majority of ventricular emboli are from what type

A

MI, stasis!

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19
Q

how do MIs lead to emboli

A

part of wall not moving so creates stasis and leads to thrombus formation

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20
Q

what can cause valvular sources of cardiac emboli

A 
rheumatic mitral stenosis
prosthetic valves
infective and non-infective endocarditis
nonbacterial thrombotic endocarditis (malignancies and prothombotic states)
calcification of valves
bicuspid aortic valves
inflammatory valvulitis
21
Q

causes of inflammatory valvulitis

A

libman sacks endocarditis (assoc with lupus)
behcet disease
syphilis

22
Q

where to arterial embolic infarcts take place that affect brain

A

carotid artery atherosclerosis or stenosis

23
Q

what is defect that can lead to paradoxical embolie

A

patent foramen ovale

need Tx atrial septal defect

24
Q

lacunar infarcts occur where

A

subcortical areas of brain from small deep penetrating aa arising from big aa

25
Q

increases risk for lacunar infarcts

A

atheroemboli

or lipohyalinosis

26
Q

major factor lacunar infarct

A

HTN

27
Q

25% ischemic strokes are what type

A

lacunar infarcts

28
Q

Sx lacunar infarcts

A

frequently asymptomatic

29
Q

lipohyalinosis

A

high pressure of L arteries transmitted to small arteries
hyperplasia small vessels
hyalinization of vessel walls
narrowing then occlusion

30
Q

Watershed infarcts

A

ischemic infarcts of areas farthest from the large aa

most sensitive is when perfusion decreases

31
Q

watershed infarcts develop in what conditions

A

sepsis
severe bleeding
severe dehydration

32
Q

Where are the cortical border zones

A

between ACA and MCA

between MCA and PCA

33
Q

3 parts that normally control state of homeostatic equilibrium

A

coagulation system
anticoagulation system
thrombolytic system

34
Q

what leads to hypercoagulable states

A

promote coagulation over anti-coagulation

35
Q

hypercoagulable states clot what type vessels

A

veins more than arteries

36
Q

what are the hypercoagulable disorders

A 
Factor V mutation
Protein C or S deficiency
antithrombin deficiency
plasminogen deficiency
prothrombin gene mutation
37
Q

what disorders are more likely to cause arterial clotting

A

antiphospholipid antibody syndrome

hyperhomocysteinemia

38
Q

what do you detect in antiphospholipid Ab syndrome

A

anticardiolipin Ab

Lupus anticoagulants

39
Q

hypercoagulable states from other processes

A

cancer
pregnancy
hormone replacement therapy
prlonged bed rest or immobility, heart attack, stroke
myeloproliferative disorders such as polycythemia vera or essential thrombocytosis

40
Q

vertebral dissection seen in what sport

A

golfing from cerebral dislocation

41
Q

causes of strokes not hypercoagulation

A

vasculitis
vasospasm
moyamoya disease

42
Q

vasospasms causing stroke seen in

A

subarachnoid bleeding, cocaine use

43
Q

moyamoya disease

A

poorly understood occlusive disease involving large intracranial aa

44
Q

stroke presentation depends on

A

size of affected vessel

area of brain supplied by affected vessel

45
Q

hemiparesis

A

weakness of one side of body

46
Q

hemiplegia

A

complete paralysis of one side of body

47
Q

homonymous hemianopsia

A

loss of vision in same visual field of both eyes

48
Q

acalculia

A

difficulty to perform simple math tasks

49
Q

agnosia

A

inability to recognize objects, persons, sounds, shapes or smells

Year 2 neuro exam 2 (23 decks)

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