Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology > OME - Stroke > Flashcards

OME - Stroke Flashcards

1
Q

3 types of stroke?

A
  1. Thrombotic:Ischemic
  2. Embolic: Ischemic
  3. Hemorrhagic stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of hemorrhage is a hemorrhagic stroke?

A

Intracerebral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors thrombotic stroke?

A

Same as MI:

  1. Smoking
  2. Obesity
  3. FH
  4. TIIDM, Htn, Hld
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sources embolic stroke?

A
  1. Carotid artery stenosis
  2. A fib
  3. Bad valve in heart
  4. Septic from IE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentation stroke?

A
  1. Focal neurologic deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do the anterior cerebral arteries feed?

A
  1. Feet

2. Legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does MCA feed?

A
  1. Hands
  2. Arms
  3. Face
  4. Speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What to PCA feed?

A
  1. Visual Cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the basilar artery arrive from?

A

2 vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can cause locked in syndrome?

A

Occlusion basilar artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presentation occlusion vertebral basilar System?

A

Syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What controls coordination?

A

Cerebellum - finger to nose, ambulation (ataxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What side of body does right brain stroke impact?

A

Left body, and vice versa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is bilateral body nuero loss ever stroke?

A

Never a SINGLE stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Presentation stroke patient?

A
  1. Vasculopath
  2. Afib/flutter, valve no on coag
  3. Young woman c/o neck pain post trauma
    - Could be a carotid dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Cushing syndrome?

A

Sign of intracerebral hemorrhage.

  1. Altered breathing
  2. Bradycardia
  3. Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

First step someone comes in w/ possible stroke?

A

Non contrast CT head

  • The purpose is to rule out bleed
  • Blood is white w/o contrast
  • Also much rapider as don’t have to wait for contrast to distribute
18
Q

Next step in hemorrhagic stroke after diagnosis?

A
  1. Drop BP with drip
  2. Call neuro: coil? clip? craniotomy?
  3. FFP if INR elevated
19
Q

How does clip work? Coil?

A

Clip: need to open brain to close off vessel
Coil: Need to go through vessel

20
Q

Next step after diagnosing nonhemorrhagic stroke?

A

Decide if we give TPA

21
Q

Work up ischemic stroke if survive?

A
  1. 2d Echo (TTE) - vegetation?
  2. Carotid US -
  3. EGK monitoring - Afib or flutter?
22
Q

Next step if stroke and afib or flutter?

A 
Anticoagulation:
1. Warfarin
or
2. NOAC
***Heparin bridge NOT needed
23
Q

Next step in stroke if thrombus on TTE?

A 
Anticoagulation:
1. Warfarin
or
2. NOAC
***Heparin bridge IS needed
24
Q

Next step in stroke if Carotid artery stenosis?

A
  1. Less than 70% no symptoms:
    - Medical mgmt
  2. Greater 70% symptomatic:
    - Surgical mgmt
  3. Greater 80% no symptoms:
    - Surgical MGMT
25
What is the penumbra?
Area around stroked out area that is at risk - Used to wait on enterectomy to preserve - Now we no longer wait
26
What is CPP?
"Cerebral perfusion pressure" | - MAP minus ICP
27
Who gets TPA?
1. Over 18 2. Focal neurologic stroke 3. Less than three hours - 4.5 non diabetics 4. BP under 180/105
28
Contraindication tPA?
1. History Brain bleed 2. Recent surgery 3. Risk of bleeding - GI bleed?
29
Acute management stroke no tPA?
1. No heparin 2. No anticoag 3. Antiplatelet - Aspirin 325g 4. Control sugars - mildly - HYPOglycemia risk for low perfusion 5. Permissive htn first 24 hours - 220 / 120
30
Why do we allow permissive htn in first 24 hours?
Body is upregulating BP to increase blood flow to save penumbra tissue
31
Chronic management stroke no tPA?
1. LMWH if paralyzed or immobile 2. Anticoag - valve, fib / flutter 3. Aspirin +/- clopidogrel 4. Atorva 40 or 80 - Rosuvastatin 20 or 40 5. A1C under 8 6. Control BP
32
Why not give CT contrast in stroke?
Contrast looks same as blood
33
What are we looking for in CT perfusion?
Penumbra - area around infarcted tissue we can hopefully save
34
At what NIH class are we thinking large occlusion?
Over 6
35
When does TPA need to be given?
Within 4.5 hours
36
TPA contraindications?
1. NOAC 2. Coumadin over 1.7 3. History head bleed 4. Platelet under 100 5. BP over 185/110 6. MI within 3 months 7. Hypoglycemia
37
Dosing TPA?
0. 9 mg / kg with max dose 90 - 10% in first minute - Remainder over an hour
38
How to manage BP after TPA?
180/100
39
CPP equation?
CPP = MAP - ICP
40
Timeframe thrombectomy?
24 hours

Neurology (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions