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Medicine > Kumar & Clark > Flashcards

Kumar & Clark Flashcards

1
Q

What is the annual incidence of stroke in Africans?

A

315/100,000

This figure indicates the frequency of stroke occurrences within a specific population.

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2
Q

What is the prevalence of stroke in Africans?

A

1460/100,000

Prevalence refers to the total number of cases in a population at a given time.

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3
Q

How does the incidence and prevalence of stroke in Africans compare to Europeans and North Americans?

A

2-3 fold higher incidence and prevalence

This highlights significant disparities in stroke rates across different populations.

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4
Q

What is the 3-year fatality rate for stroke in Africans?

A

80%

This statistic underscores the severity and outcomes associated with strokes in this demographic.

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5
Q

Which gender has a higher incidence of stroke in Africans?

A

Males

Gender differences can influence stroke risk and outcomes.

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6
Q

What age group is most commonly affected by stroke?

A

4th to 6th decade of life

This indicates that middle-aged individuals are at higher risk.

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7
Q

List some common investigations for stroke.

A
  • CXR
  • ECG
  • Echocardiogram
  • Coronary angiogram
  • Serum biochemistry
  • Full blood count/ESR
  • Peripheral blood analysis
  • Serology (fungal, RVS, HBsAg, Anti HCV, Syphilitic assay)
  • Fungal studies
  • Fundoscopy
  • Renal scan
  • Pelvic scan
  • Bone assay
  • Thyroid hormone assay
  • Lipid profile
  • Liver function test
  • Hormonal assay
  • Clotting profile

These investigations help in diagnosing and managing stroke effectively.

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8
Q

What is the drug of choice (DOC) for ischemic stroke?

A

IV Alteplase

Alteplase is a thrombolytic agent used to dissolve blood clots.

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9
Q

What is a better alternative to IV Alteplase for ischemic stroke treatment?

A

Tenecteplase

Tenecteplase is known for its efficacy and convenience in administration.

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10
Q

What are some treatments for hemorrhagic stroke?

A
  • Antihypertensive therapy (CCBs, ACEIs, BBs, Hydralazine)
  • Vitamin K
  • Fresh frozen plasma
  • Prothrombin complex concentration
  • Platelet concentrate
  • Decompressive craniectomy
  • Stereotactic or endoscopic aspiration

These treatments aim to manage bleeding and stabilize the patient.

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11
Q

What is the target SBP for patients presenting with hemorrhagic stroke?

A

140 mmHg

Maintaining blood pressure within this range is critical to prevent further complications.

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12
Q

What is the significance of a GCS greater than 9 in hemorrhagic stroke?

A

Indicates surgical evacuation may be necessary

GCS (Glasgow Coma Scale) is crucial for assessing consciousness and guiding treatment.

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13
Q

What are the types of ischemic stroke?

A
  • Cardio-embolic stroke
  • Thromboembolic stroke
  • Lacunar strokes

Each type has distinct causes and implications for treatment.

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14
Q

What is the pathophysiology of ischemic stroke?

A

Reduced blood and oxygen supply

This leads to tissue damage and neurological deficits.

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15
Q

What percentage of hemorrhagic strokes are classified as intracerebral hemorrhage (ICH)?

A

80-85%

ICH is a common form of hemorrhagic stroke, often spontaneous.

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16
Q

What are the main risk factors for stroke?

A
  • Hypertension
  • Diabetes
  • Smoking
  • Hyperlipidemia
  • Atrial fibrillation
  • Sedentary lifestyle
  • Obesity
  • Poor diet

Addressing these factors can significantly reduce stroke risk.

17
Q

What is the prognosis for patients with ischemic stroke?

A

Good in initial phase with prompt and effective treatment

Early intervention greatly improves outcomes.

18
Q

What defines a stroke?

A

Acute clinically defined focal neurological deficit of vascular origin that persists for more than 24 hours

This definition emphasizes the urgency and nature of stroke as a medical condition.

19
Q

Which clinical features are common in stroke patients?

A
  • Muscle weakness or paralysis
  • Speech abnormality
  • Seizures
  • Hypertension
  • Headache
  • Depression
  • Contractures
  • Urinary/ fecal incontinence

Recognizing these features can aid in early diagnosis and treatment.

20
Q

What is the role of neuroprotective agents in stroke management?

A
  • Flavonoids
  • Nicotinamide
  • Deferoxamine
  • Nimodipine
  • Vitamin E

These agents help protect brain tissue following an ischemic event.

21
Q

What is the expected trend for stroke survivors by 2030?

A

77 million stroke survivors projected

This reflects the increasing incidence and improvements in management.

22
Q

What is the difference between primary, secondary, and tertiary prevention in stroke?

A
  • Primary: prevent the first episode
  • Secondary: prevent a repeat stroke
  • Tertiary: secondary prevention plus total patient care

Each level of prevention targets different stages of stroke risk and recovery.

23
Q

What are some differential diagnoses for stroke?

A
  • Meningitis
  • Acute subdural hematoma
  • AV malformation
  • Dural sinus thrombosis
  • Pituitary apoplexy
  • Acute hypertensive crisis
  • Cervical artery dissection

These conditions can present with similar symptoms and must be considered.

24
Q

What is the importance of controlling prognostic features in stroke rehabilitation?

A

Stabilization of recovery and prevention of further strokes

Effective rehabilitation can lead to better outcomes and quality of life.

Medicine (3 decks)

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