Kumar & Clark Flashcards
What is the annual incidence of stroke in Africans?
315/100,000
This figure indicates the frequency of stroke occurrences within a specific population.
What is the prevalence of stroke in Africans?
1460/100,000
Prevalence refers to the total number of cases in a population at a given time.
How does the incidence and prevalence of stroke in Africans compare to Europeans and North Americans?
2-3 fold higher incidence and prevalence
This highlights significant disparities in stroke rates across different populations.
What is the 3-year fatality rate for stroke in Africans?
80%
This statistic underscores the severity and outcomes associated with strokes in this demographic.
Which gender has a higher incidence of stroke in Africans?
Males
Gender differences can influence stroke risk and outcomes.
What age group is most commonly affected by stroke?
4th to 6th decade of life
This indicates that middle-aged individuals are at higher risk.
List some common investigations for stroke.
- 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.
What is the drug of choice (DOC) for ischemic stroke?
IV Alteplase
Alteplase is a thrombolytic agent used to dissolve blood clots.
What is a better alternative to IV Alteplase for ischemic stroke treatment?
Tenecteplase
Tenecteplase is known for its efficacy and convenience in administration.
What are some treatments for hemorrhagic stroke?
- 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.
What is the target SBP for patients presenting with hemorrhagic stroke?
140 mmHg
Maintaining blood pressure within this range is critical to prevent further complications.
What is the significance of a GCS greater than 9 in hemorrhagic stroke?
Indicates surgical evacuation may be necessary
GCS (Glasgow Coma Scale) is crucial for assessing consciousness and guiding treatment.
What are the types of ischemic stroke?
- Cardio-embolic stroke
- Thromboembolic stroke
- Lacunar strokes
Each type has distinct causes and implications for treatment.
What is the pathophysiology of ischemic stroke?
Reduced blood and oxygen supply
This leads to tissue damage and neurological deficits.
What percentage of hemorrhagic strokes are classified as intracerebral hemorrhage (ICH)?
80-85%
ICH is a common form of hemorrhagic stroke, often spontaneous.
What are the main risk factors for stroke?
- Hypertension
- Diabetes
- Smoking
- Hyperlipidemia
- Atrial fibrillation
- Sedentary lifestyle
- Obesity
- Poor diet
Addressing these factors can significantly reduce stroke risk.
What is the prognosis for patients with ischemic stroke?
Good in initial phase with prompt and effective treatment
Early intervention greatly improves outcomes.
What defines a stroke?
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.
Which clinical features are common in stroke patients?
- Muscle weakness or paralysis
- Speech abnormality
- Seizures
- Hypertension
- Headache
- Depression
- Contractures
- Urinary/ fecal incontinence
Recognizing these features can aid in early diagnosis and treatment.
What is the role of neuroprotective agents in stroke management?
- Flavonoids
- Nicotinamide
- Deferoxamine
- Nimodipine
- Vitamin E
These agents help protect brain tissue following an ischemic event.
What is the expected trend for stroke survivors by 2030?
77 million stroke survivors projected
This reflects the increasing incidence and improvements in management.
What is the difference between primary, secondary, and tertiary prevention in stroke?
- 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.
What are some differential diagnoses for stroke?
- 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.
What is the importance of controlling prognostic features in stroke rehabilitation?
Stabilization of recovery and prevention of further strokes
Effective rehabilitation can lead to better outcomes and quality of life.
