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PHCY 310 > L 43 > Flashcards

L 43 Flashcards

1
Q

3 types of ischaemic stroke (normal 2 + another)?

A

Thrombotic, embolic

+ Transient

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2
Q

2 types of haemorrhagic strokes

A

Intracerbral (ICH) and subarachnoid (SAH)

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3
Q

What do these stand for: “A stroke = CVA = CVAE”

A

A stroke = cerbrovascular accident = cerebrovascular adverse event

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4
Q

ACS and angina are types of … which are … … rich clots

A

ACS and angina are types of IHD which are white platelet rich clots

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5
Q

DVT and PE are types of… which are … … rich clots

A

DVT and PE are types of VTE which are red fibrin rich clots

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6
Q

Along with heart disease, stroke is the … cause of death and disability in NZ

A

Along with heart disease, stroke is the leading cause of death and disability in NZ.

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7
Q

Around 25% of ischaemic strokes are …

A

Around 25% of ischaemic strokes are embolic

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8
Q

Biggest modifiable risk factors for stroke (without history)

A

Cigarette smoking and hypertension

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9
Q

Sudden stroke signs and symptoms x5

A
  • Weakness/numbness of face/arm/leg on one side
  • Blurred or loss of vision in one or both eyes
  • Dysarthria or aphasia
  • Sudden dizziness, loss of balance, difficulty controlling movements
  • Headaches (more common in haemorrhagic stroke)
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10
Q

Stroke complications x4

A
  1. Mortality
  2. Permanent loss of function
  3. Long term: impaired vision/speech, hemiparesis, limb hemiplagia, dysphagia, memory loss, depression.
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11
Q

Hemiparesis

A

Severe weakness on one side of body

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12
Q

Hemiplegia

A

Paralysis of one side of the body

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13
Q

Stroke diagnostics x6

A
  • Clinical assessment
  • Blood glucose
  • Platelets and coagulation screen
  • Head CT to rule out haemorrhagic stroke
  • Head MRI to show area and extent of ischaemia
  • ECG (especially if at risk of AF)
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14
Q

Principles of stroke treatment x4

A

Prevention of stroke
Quick recognition, treatment, and propagation prevention
Brain recovery and rehabilitation
Secondary prevention (HTN, AF etc)

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15
Q

NP treatments for stroke (similar to IHD) x6

A
  • Nutritional advice
  • Regular physical activity and weight loss
  • Moderation of alcohol consumption
  • SMOKING CESSATION!
  • Surgery (reperfuse brain or repair damaged vessel)
  • Brain recovery and rehab (physio, speech, occupational therapy)
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16
Q

Short term treatment strategy for ischaemic stroke (4.5h-24h)

A
  • Revascularisation (thrombectomy or fibrinolytics) !!!!
  • IV DHP CCB only if BP >220/120 mgHg (don’t do if diastolic <80 as will be too low).
  • Antiplatelets (e.g aspirin +/- clopidogrel), 24 hours after alteplase therapy.
17
Q

What does TIME IS BRAIN mean

A

Every minute that the stroke is not treated, more of the brain is getting damaged.
Long term treatment strategy for ischaemic stroke

18
Q

Reduce risk factors AND…

A

If cardioembolic warfarin (or dabigatran or rivaroxaban)
If non-cardioembolic aspirin (+ dipyridamole) or clopidogel
+ moderate/high intensity statin
+ ACEI +/- thiazide, ARB or CCB if BP >140/90mmHg

19
Q

Cardioembolic

A

Stroke due to blood clot in the heart traveling to the brain.

20
Q

Why are the treatments different for cardioembolic or non-cardioembolic strokes?

A

Because with a cardioembolic stroke, the blood will be stagnating and causing red clots, therefore you need anticoagulants not antiplatelets.

21
Q

Anticoagulants are used to treat:

A

Red clots, fibrin rich. They reduce fibrin formation to prevent clots from forming and growing.

22
Q

Antiplatelets are used to treat:

A

White clots, platelet rich. They prevent platelets from clumping together and therefore prevent white clots from forming.

23
Q

Following an ischaemic stroke, you want to get the patient’s LDL to be below …

A

2mmol/L

24
Q

Which type of stroke is more common and largely preventable?

A

Ischaemic stroke

25
Q

What is primary prevention of ischaemic stroke?

A

Management of HTN, smoking and AF.

26
Q

Treatment summary for ischaemic stroke:

PROMPT TREATMENT!

A
  • Reperfursion through alteplase or mechanical reperfusion
  • Antiplatelet therapy lifelong + high dose statin + BP management
  • Brain recovery and rehabilitation

PHCY 310 (65 decks)

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