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Medical Pathology > Lecture 4: Stroke I > Flashcards

Lecture 4: Stroke I Flashcards

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USMLE® Step 1 flashcards
1
Q

What percent of body weight is the brain

A

2%

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2
Q

what areas requires high oxygen demand

A

brain, cardiac output, and total body oxygen

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3
Q

which vessels are in the anterior 3/5 of the brain

A

internal carotids

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4
Q

which vessels join to form the basilar artery and are in the posterior 2/5 of the brain ; run through the cerebellum and brainstem

A

vertebral arteries

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5
Q

which artery is mainly assoc. with visual probs.

A

posterior cerebral artery

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6
Q

which two molecules need to be continually fed to the brain for it to function properly

A

glucose and oxygen

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7
Q

the brain has what type of neurons

A

aerobic

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8
Q

oxidative stress can cause …

A

excess glutamate ( neurotoxic neurotransmitter) ; excess ic Ca -> compromised ic signaling; re-perfusion injury -> forms ROS causing mitochondrial dysfunction

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9
Q

what is a less severe form of stroke ; brief period of inadequate cerebral perfusion

A

Transient Ischemic Attack (TIA)

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10
Q

this attack involves sudden focal loss of neurologic function; rapid onset and resolution usually followed by full recovery in 24 hours

A

TIA

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11
Q

this attack can be caused by intermittent vessel obstruction and temporary vasospasm

A

TIA

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12
Q

what % of pts will have a full on stroke if TIA not treated

A

35 %

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13
Q

These symptoms are of what disorder: hemiplegia, diplopia, transient loss of vision , vertigo, loss of speech, loss of understanding, loss of balance

A

TIA

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14
Q

this is transient loss of vision ; blood flow issue to the eye where the vision blacks out and then comes back

A

Amaurosis fugax

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15
Q

what is a differential Dx of TIA

A

migraines, seizures, hx of similar episodes

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16
Q

what are some features of non TIA events

A

lightheadedness, chest tightness, stomach upset, Hx of similar episodes where TIA was ruled out , SPEED OF ONSET

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17
Q

this is a disturbance of blood supply causing loss of brain function

A

stroke

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18
Q

this is the #4 cause of death in the US and #6 worldwide

A

stroke

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19
Q

what are people who are at high risk for stroke

A

older adults ( >65 usually), African americans, american indians, Alaska natives, low level education, Southeast US

20
Q

what are some risk factors for Stroke

A

HTN ( modifiable), Age, Patent foramen ovale , etc

21
Q

this describes a structure that is congenital and delivers oxygenated blood from mother into the arterial circulation of the fetus- it should close after birth and sometimes it doesn’t- when it doesn’t the venous circulation passes into the arterial circulation

A

patent foramen ovale

22
Q

what are the two types of strokes

A

ischemic and hemorrhagic

23
Q

which type of stroke is more common ( 80-85 %) and has mortality rate of 40%

A

ischemic ( blood supply has been cut off in some way)

24
Q

which type of stroke is less common ( 15-20%) and has mortality rate of 80%

A

hemorrhagic ( when a bv burst or breaks open and blood leaks into other areas)

25
Q

what is the most common cerebral artery affected by CVA

A

Middle Cerebral Artery

26
Q

with ischemic stroke , what are the diff types of blood vessel occlusions you can have

A

thrombotic, embolic, lacunar, and dissection ( carotid or vertebral)

27
Q

with ischemic stroke , what are the diff types of systemic hypoperfusion you can have

A

pump failure, and hypovolemia

28
Q

these areas of ischemic stroke are most at risk areas; no redundant blood supply ; minimally perfused area ; between major arteries

A

watershed areas

29
Q

this area of ischemic stoke has blood flow

A

ischemic core

30
Q

this area of ischemic stroke has blood flow between 40-15 % normal ; least severe pt of CVA’ some collateral blood flow possible

A

ischemic penumbra

31
Q

this disorder involves plaque fragments from carotids; chronic atrial fibrillation; fat particles; gas bubbles; bacterial endocarditis; IV substance abuse

A

embolic stroke

32
Q

this type of stroke deals with intracranial artery rupture ( hypoxic and hydraulic damage)

A

hemorrhagic stroke

33
Q

common causes of this stroke include HTN, aneurysm , AV malformation, and trauma; sudden onset and severe

A

hemorrhagic stroke

34
Q

what are the two locations of a hemorrhagic stroke

A

extra-axial ( outside brain tissue) and intra- axial ( inside brain tissue)

35
Q

what are the three locations of an extra-axial hemorrhagic stroke

A

epidural, subdural, and subarachnoid

36
Q

this type of extra- axial hemorrhagic stroke is caused by head trauma and involves the middle meningeal artery

A

epidural

37
Q

this type of extra- axial hemorrhagic stroke is usually due to acceleration/deceleration injury and is found in elderly and alcoholics

A

subdural

38
Q

this type of extra- axial hemorrhagic stroke is congenital or traumatic and can cause severe HA -> papilledema

A

subarachnoid

39
Q

this type of hemorrhagic stroke involves rupture and hemorrhage into the brain ( hypoxic and hydraulic injury )

A

intra-axial cerebral hemorrhagic stroke

40
Q

these disorders are associ with what type of hemorrhagic stroke: HTN, AVM, Berry aneurysms, trauma

A

Intra-axial cerebral hemorrhagic stroke

41
Q

what % of strokes happen in adults less than 65 YO

A

25 % ( majority are ischemic) , 45% are hemorrhagic

42
Q

what causes strokes in adults less than 65 YO

A

trauma, oral contraceptives, pregnancy, post partum, HTN, DM, obesity, smoking, atherosclerosis

43
Q

which two types of ischemic strokes are involved in young adults

A

carotid artery and vertebral artery dissection

44
Q

this type of dissection can be traumatic or spontaneous; symptoms include HA or neck pain, horners syndrome, transient vision loss, ischemic stroke

A

carotid artery dissection

45
Q

this type of dissection is similar to carotid artery dissection

A

vertebral artery dissection

46
Q

what is it called when the intenal wall of the bv becomes compromised from a tear and the blood pushes over the inner lining and causes a fake valve to occur and cuts off blood supply

A

dissection

Medical Pathology (11 decks)

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