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OPIC > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a CVA?

A

Cerebrovascular accident

Sudden interruption to the blood supply of the brain

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2
Q

What are the broad types of stroke?

A

Ischaemic

Haemorrhagic

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3
Q

What is a TIA?

A

Transient ischaemic attack

Symptoms of a stroke that resolve within 24 hours

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4
Q

What are risk factors for a stroke?

A 
HTN
DM
Hyperlipidaemia
AF
Previous stroke/TIA
Anticoagulation therapy
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5
Q

What tools can be used for stroke assessment?

A

FAST

ROSIER (recognition of stroke in emergency room)

NIHSS

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6
Q

What classification system is used for stroke?

A

Oxford

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7
Q

What are the different types of stroke under the Oxford classification system?

A

TACs
PACs
LACs
POCs

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8
Q

What are the features of a TACs?

A

Total anterior circulation

Sensory or motor loss
Homonymous hemianopia
Higher cognitive dysfunction

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9
Q

What are the features of a PACs?

A

Partial anterior circulation

2 of

  • Sensory or motor loss
  • Homonymous hemianopia
  • Higher cognitive dysfunction
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10
Q

What are the features of a LACs?

A

Lacunar (internal capsule, thalamus, basal ganglia)

1 of

  • pure motor
  • pure sensory
  • pure sensorimotor
  • ataxic hemiparesis
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11
Q

What are features of a POCs?

A

Posterior circulation

1 of

  • ipsilateral CN palsy + contralateral motor/sensory deficit
  • bilateral sensory/motor deficit
  • cerebellar signs
  • brainstem syndrome
  • isolated homonymous hemianopia
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12
Q

How should suspected strokes be investigated?

A

BM - rule out hypoglycaemia

CT - rule out haemorrhage

ECG - AF

Carotid USS

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13
Q

When shoudl carotid disease be managed?

A

Blockage >50% + symptomatic

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14
Q

How is carotid disease managed?

A

Carotid endarterectomy

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15
Q

How can ischaemic strokes be managed?

A

Thrombolysis
Thrombectomy
Anti-platelets

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16
Q

What thrombolysis agent is used?

A

Alteplase

IV by weight

17
Q

When can thrombolysis be given?

A

Within 4.5 hours of onset of stroke

18
Q

What are contraindications for thrombolysis?

A 
Previous ICH
Seizure with onset of stroke
Intracranial neoplasm 
Stroke/TBI in previous 3 months
LP in previous 7 days
GI haemorrhage in previous 3 weeks
Active bleeding
Pregnancy 
BP >200/120
19
Q

What are the indications for thrombectomy?

A

Within 6 hours of stroke onset
Large vessel occlusion seen on MRA/CTA
NIHSS >6

20
Q

What anti-platelet agents are used in ischaemic stroke?

A

300mg aspirin OD for 2 weeks

Then clopidogrel 75 mg PO OD

21
Q

How are haemorrhagic strokes managed?

A

BP control

+/- neurosurgery

22
Q

What stroke secondary prevention is used?

A

BP control
Statins
DM control

23
Q

Who is involved in stroke rehab?

A

PT
OT
SALT
Dieticians

OPIC (8 decks)

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