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Neuro II Exam 3 > Lecture 6: Stroke > Flashcards

Lecture 6: Stroke Flashcards

1
Q

Which 6 cardiac disorders are a risk factor for stroke?

A

1) Valvular heart disease (dysf. or prosthetic valve)
2) Cardiac dysrhythmia (i.e., atrial fibrillation)
3) Mural thrombus
4) Endocarditis
5) Atrial myxoma
6) Interatrial septal abnormalities

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2
Q

Which legal and illegal drugs are risk factors for strokes?

A
  • IVDA
  • Cocaine
  • Amphetamines
  • Oral contraceptives
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3
Q

Fibromuscular dysplasia is a risk factor for _______

A

Stroke

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4
Q

Which 6 inflammatory disorders are risk factors for stroke?

A
  1. Giant cell arteritis
  2. SLE
  3. Polyarteritis Nodosa
  4. Granulomatous Angitis
  5. Syphilitc Arteritis
  6. AIDS
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5
Q

T/F migrains are a risk factor for stroke?

A

True

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6
Q

What are the symptoms of a stroke occuring in the left hemisphere?

A
  • Aphasia
  • Right sided sensory and motor symptoms
  • Right visual field cut
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7
Q

What are the symptoms of a stroke occuring in the right hemisphere?

A
  • Left hemineglect
  • Left sided sensory and motor symptoms
  • Left visual field cut
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8
Q

What are the symptoms of a stroke occuring in the cerebellum?

A
  • Ipsilater ataxia
  • Vertigo
  • Nystagmus
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9
Q

What are the symptoms of a stroke occuring in the brainstem?

A
  • CN findings w/ contralateral hemisensory or hemimotor sx’s
  • Vertigo
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10
Q

How should acute HTN be treated with an ischemic stroke?

Why?

A
  • Should NOT be treated
  • Area of infarction may have lost autoregulatory function, so that “normal” BP may be relatively hypotensive in the brain
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11
Q

How should IV’s be utilized in the treatment of stroke patients?

What should not be included in the IVF’s?

What about if tPA is to be given?

A
  • All stroke patients need to have IV access
  • IVF’s should NOT include glucose as hyperglycemia is associated with worse neurologic outcomes
  • If tPA is a consideration, 2 IV access sites will be needed to eliminate venipuncture after infusion
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12
Q

What is the NIH stroke scale used for?

What is the score range?

A
  • Important if tPA or intra-arterial intervention is a consideration
  • Range from 0 (normal) to 42 (coma)
  • Used to predict hemorrhagic conversion as well as indication for potential intra-arterial intervention
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13
Q

What does a score of <10 and >20 on the NIH stroke scale tell you?

A
  • Score <10 = 2-3% risk of hemorrhage
  • Score >20 = 17% risk of hemorrhage
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14
Q

What must be done if a fever is present in a patient presenting with a stroke?

A

Must be treated, as fever will worsen stroke outcome long-term

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15
Q

If the CT findings are normal in a patient believe to have suffered a stroke, what are some other causes you should consider?

A

Seizure, migraine, hypoglycemia, etc.

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16
Q

Administering tPA for the treatment of acute ischemic stroke should be given within _______ hours of the onset of symptoms.

A

3 hours (better within 1.5 hours)

*She said up to 4.5 hours

17
Q

Which clinical situations is warfarin (or one of the new generation anticoagulants - NOAC’s) generally indicated?

*She stressed this!!!

A
  • Atrial fibrillation
  • Prosthetic valve
  • MI
  • Atrial septal defect
  • Hypercoagulable state
  • Large vessel disease
  • Aortic arch disease
18
Q

Which 2 anticoagulants can be used in combination during the first few weeks after stroke?

A

ASA + Plavix

19
Q

When should a carotid angioplasty w/ stent placement be considered in a stroke patient?

A
  • When pt at high risk for surgery
  • Severe CAD or valvular heart disease, distal carotid disease, or bilateral severe carotid disease
20
Q

What is the significance of endovascular therapy (intra-arterial thrombolysis w/ clot retrieval) in patients with strokes?

A

Multiple studies have showed improvement in patients treated with endovascular/intra-arterial intervention in addition to tPA when compared to tPA alone

21
Q

What are some conditions that can present w/ focal neuro deficits that may be confused with stroke?

A

1) Migrane w/ aura (primary headace disorder)
2) Hyperglycemia
3) Hepatic abnormalities

Neuro II Exam 3 (17 decks)

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