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Year 4 - OPIC > Stroke > Flashcards

Stroke Flashcards

1
Q

Transient global amnesia
- Onset
- Presentation

A

Transient global amnesia
- Onset
1. Acute confusion

  • Presentation
    1. Acute confusion
    2. Same question repeatedly
  1. Neurologically normal
  2. Able to carry out ADLs
    - Procedural memory
  3. No recollection
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2
Q

Stroke mimic
- Migraine similar features

A

Stroke mimic
- Migraine features

  1. Blurring of vision
  2. Pins and needles/numbness
  3. Difficulty concentrating
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3
Q

Capsular warning syndrome
- Classification
- Features

A

Capsular warning syndrome

  • Classification
    1. TIA affecting capsule
  • Features
    1. >3 Episodes of sensory/motor Symptoms
    2. High incidence of infarction within 7 days
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4
Q

TOAST Classification
- Classes and Ix

A

TOAST Classification
- Classes

  1. Large artery atherosclerosis
    - Duplex
  2. Cardio embolic
    - ECG/TOE
  3. Small-vessel disease
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5
Q

NIH SS
- Score

A

NIH Stroke Scale
- Score

  1. Consciousness& gaze
  2. Visual and facial palsy
  3. Motor arm, motor leg, limb ataxia
  4. Sensory, language and dysarthria
  5. Extinction/inattention
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6
Q

OCSP
- Classes

A

Oxford community stroke project
- Classes

TACS
PACS
POCS
LACS

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7
Q

Thrombolysis
- contraindications

A

Thrombolysis contraindications

  1. BP>185/110 After two attempts to reduce
  2. Surgery/trauma/childbirth within 14 days
  3. Stroke within 14 days
  4. Active internal bleeding
  5. Haem abnormalities
  6. INR 1.7, APTT 40
  7. DOAC. LMWH
  8. Platelet<50
  9. Arterial puncture
  10. SAH, IE, Pericarditis, pancreatitis, liver disease
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8
Q

Thrombolysis
- Relative contraindications

A

Thrombolysis
- Relative contraindications

  1. Infarction >4.5 hr
  2. Mass effect/oedema/tumor, aneurysm
  3. Intra cranial/spine surgery
    - 2 months
  4. Neurosurgery
    - 6 weeks
  5. Stroke/head injury
    - 6 weeks
  6. GI/UT bleed
    - 6 weeks
  7. Glucose<2.7
  8. Seizure at stroke onset
  9. Symptoms start during sleep
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9
Q

Stroke imaging
- 4Ps

A

Stroke imaging
- 4Ps

  1. Pipes
    -Angiography
  2. Parenchyma
    - Non contrast CT
  3. Perfusion
    - CT/MRI perfusion scan
  4. Penumbra
    - Around ischaemic core
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10
Q

ASPECTS
Scoring

A

ASPECTS
Scoring

Alberta Stroke Program Early CT Scoring

  1. Mortality predictor
  2. Stroke topography
  3. Stroke size
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11
Q

Alteplase indications

A

Alteplase indications

  1. <4.5 hours
  2. Disabling impairments
    - NIH>4
    - Dysphagia
    - Inability to mobilise/self care
    - Visual field defect
  3. No contraindications
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12
Q

Thrombolysis
- Monitoring

A

Thrombolysis
- Monitoring

  1. Haemodynamic obs
  2. Neuro obs
  3. ICH
  4. Anaphylaxis
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13
Q

Thrombolysis
- complications

A

Thrombolysis
- complications

  1. Reaction
  2. Rising ICP
    Oedema
    - Hydrocephalus
  3. Seizure
  4. Infection
  5. Metabolic disturbances
  6. Extra cerebral haemorrhage
    - thin pulse, BP, Malaena, abdomen
  7. Intra cerebral haemorrhage
    - neuro decline, headache, BP, N&V
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14
Q

Mechanical thrombectomy
- Indications

A

Mechanical thrombectomy
- Indications

  1. Large artery occlusion
    - MRS>1
    - NIHSS - 5
  2. Fibrinolysis contraindicated
  3. No response to alteplase
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15
Q

Stroke prevention
- Targets

A

Stroke prevention
- Targets

  1. Life style
  2. Anti thrombotic
  3. BP
  4. Lipids
  5. Glycaemic
  6. Carotid endarterectomy
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16
Q

AF and stroke
- Assessment
- Prevention

A

AF and stroke

  • Assessment
    1. CHADS VASC
    (NB HasBled/ Orbit)
  • Prevention
    1. DOAC
    2. Warfarin
17
Q

Carotid disease
- Mx

A

Carotid disease
- Mx

  1. BMT (best medical)
    - BP, statin, glycaemic, dual antiplatelet
  2. CEA
    - Carotid endarterectomy
  3. Carotid stenting
18
Q

IQ
- significant impairment
- % population

A

IQ

  • significant impairment
    <70
  • 2% population
19
Q

Intellectual disability

  • Definition
A

Intellectual disability
- Definition

  1. Intelligence impairment ( IQ70)
  2. Adaptive functioning impairment
  3. Evident before adulthood
20
Q

Intellectual disability
- Adaptive functioning

A

Intellectual disability
- Adaptive functioning

  1. Manage ADLs
  2. Support requirements
21
Q

Intellectual disability
- DDx

A

Intellectual disability
- DDx

  1. Specific learning difficulty
  2. ADHD/ASD
  3. Head injury/cognitive decline
22
Q

Intellectual disability
- CP
- Epilepsy
- Chromosome
- Mental health

A

Intellectual disability
- CP
50% have ID

  • Epilepsy
    40% With ID have
  • Chromosome
    Fragile X causes
  • Mental health
    25-50% will have
23
Q

Causes of intellectual disabilities
- Clarifications

A

Causes of intellectual disabilities
- Clarifications

  1. Pre natal
  2. Peri natal
  3. Post natal
24
Q

Intellectual disability
- Pre natal causes

A

Intellectual disability
- Pre natal causes

  1. Genetic
    T21, Fragile X
  2. Syndromes
    CP, Spina bifida
  3. Environmental
    - malnutrition, drugs, vertical transmission
25
T21 - prevalence - associations
T21 - prevalence 1/660 - associations 1. Depression 2. Dementia 3. Hypothyroid
26
Fragile X - prevalence - features
Fragile X - prevalence 1. 1/2000 males - features 1. High forehead, large ears, long face 2. Large testes 3. Connective tissue weakness 4. Social anxiety 5. Aggression, hyperactivity, attention deficit, self injury
27
Intellectual disabilities - peri natal causes
Intellectual disabilities - peri natal causes 1. Biomedical - infections eg. Toxoplasmosis 2. Environmental - Asphyxia, prematurity
28
Intellectual disabilities - post natal causes
Intellectual disabilities - post natal causes 1. Biomedical - Epilepsy, meningitis, measles 2. Environmental - Head injury, NAI, lead/Mercury, malnutrition
29
Intellectual disabilities - Levels
Intellectual disabilities - Levels 1. Mild 50-69 2. Moderate 35-50 3. Severe <35
30
Intellectual disabilities - Mild features
Intellectual disabilities - Mild features 1. Delayed but everyday speech 2. Independent living possible 3. Able to read, write, simple maths
31
Intellectual disability - Moderate features
Intellectual disability - Moderate features 1. Delayed, simple phrase speech 2. Limited self care 3. Limited reading, writing, maths 4. Delayed mobility milestones 5. Risk of epilepsy and other neuro disorders
32
Intellectual disability - Severe/profound features
Intellectual disability - Severe/profound features 1. Severe language delay - or absent 2. Limited understanding 3. Mainly incontinent 4. 24hr supervision required 5. Frequent musculoskeletal abnormalities 6. Autism common 7. Neurological disorders and sensory deficits prevalent
33
ID psychiatry - history
ID psychiatry - history 1. Standard history 2. Developmental 3. Forensic 4. Current social and care package 5. Risk assessment
34
Stroke - Care bundle
Stroke - Care bundle 1. Admission to stroke unit 2. Revascularization therapy 3. Early complication intervention 4. Nutritional support 5. Secondary prevention 6. Rehabilitation
35
Thrombolysis and thrombectomy - Time window
Thrombolysis and thrombectomy - Time window 1. Alteplase 4.5hr 2. Thrombectomy 6hr

Year 4 - OPIC (5 decks)

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