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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
Q

T21

  • prevalence
  • associations
A

T21

  • prevalence
    1/660
  • associations
    1. Depression
    2. Dementia
    3. Hypothyroid
26
Q

Fragile X
- prevalence
- features

A

Fragile X

  • prevalence
    1. 1/2000 males
  • features
    1. High forehead, large ears, long face
    2. Large testes
    3. Connective tissue weakness
  1. Social anxiety
  2. Aggression, hyperactivity, attention deficit, self injury
27
Q

Intellectual disabilities
- peri natal causes

A

Intellectual disabilities
- peri natal causes

  1. Biomedical
    - infections eg. Toxoplasmosis
  2. Environmental
    - Asphyxia, prematurity
28
Q

Intellectual disabilities
- post natal causes

A

Intellectual disabilities
- post natal causes

  1. Biomedical
    - Epilepsy, meningitis, measles
  2. Environmental
    - Head injury, NAI, lead/Mercury, malnutrition
29
Q

Intellectual disabilities
- Levels

A

Intellectual disabilities
- Levels

  1. Mild 50-69
  2. Moderate 35-50
  3. Severe <35
30
Q

Intellectual disabilities
- Mild features

A

Intellectual disabilities
- Mild features

  1. Delayed but everyday speech
  2. Independent living possible
  3. Able to read, write, simple maths
31
Q

Intellectual disability
- Moderate features

A

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
Q

Intellectual disability
- Severe/profound features

A

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
Q

ID psychiatry
- history

A

ID psychiatry
- history

  1. Standard history
  2. Developmental
  3. Forensic
  4. Current social and care package
  5. Risk assessment
34
Q

Stroke
- Care bundle

A

Stroke
- Care bundle

  1. Admission to stroke unit
  2. Revascularization therapy
  3. Early complication intervention
  4. Nutritional support
  5. Secondary prevention
  6. Rehabilitation
35
Q

Thrombolysis and thrombectomy
- Time window

A

Thrombolysis and thrombectomy
- Time window

  1. Alteplase 4.5hr
  2. Thrombectomy 6hr

Year 4 - OPIC (5 decks)

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