Stroke Flashcards

(39 cards)

1
Q

What is the definition of a stroke?

A

sudden onset of focal neurologic deficit resulting from the interruption of blood flow to an area in the brain

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

What word should you know for stroke?

A

FAST
face
arms
speech
time

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

List some symptoms after a stroke

A

weakness or paralysis
problems with balance or coordination
problems using language
pain, numbness or odd sensations
problems with memory, thinking, attention or learning

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

What are the two main types of stroke?

A

hemorrhagic
ischemic

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

What are some facts and risk associated with hemorrhagic stroke?

A

higher death rate
higher morbidity

Risk
-aneurysm
-hypertension
-medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the types of ischemic stroke

A

atherosclerosis
cryptogenic
cardioembolic
lacunar
other causes

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

Define cardioembolic stroke

A

certain conditions can result in thrombus generation
this breaks off and gets stuck in small cerebral vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the focus of prevention for cardioembolic stroke?

A

use of anticoagulant

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

What condition will show on ECG for stroke?

A

it will be a cardioembolic stroke as it is caused by A fib or mechanical heart valves

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

What will be used to diagnosis cardioembolic stroke?

A

ECG will show A Fib
Left atrial thrombus will be seen on echocardiogram

absence of sign. atherosclerosis on imaging

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

What will happen at the ER if there are signs of Stroke?

A

Imaging to see if it is ischemia and hemorrhage
look at ECG
see what is decided based on results

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

When do you use thrombolysis?

A

before 4.5 hours after first symptoms and it is ischemic

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

What are fibrinolytics?

A

plasminogen activators
breaks up clots

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

What is alteplase?

A

extract human sequence of tPA
requires 1 hour infusion time

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

What is tenecteplase?

A

longer acting fibrinolytic
can be administered with a single IV bolus dose
more convenient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two types of fibrinolytics

A

alteplase (tPA)
tenecteplase

17
Q

Why is it important to use fibrinolytic therapy within 3 hours?

A

it will decrease the risk for poor stroke outcomes

18
Q

What are CI for tPA

A

rapidly improving
hemorrhage on CT
seizures
recent stroke (3 months)
recent GI/UTI bleed (3 wks)
low platelets
recent anticoag (2 days)
history of ICH

19
Q

What to do if not eligible for TPA and not hemorrhage?

A

antiplatelet therapy

20
Q

When is anticoagulation used?

A

cardioembolic strokes
-A Fib
Mechanical heart valves
Severe HF

21
Q

LIst the Antiplatelet agents

A

COX inhibitors
ADP receptors antagonists
inference with cyclic AMP
GP IIb/IIIa antagonists

22
Q

What is the first line antiplatelet?

23
Q

When is it CI to use ASA as secondary prevention of stroke?

A

certain pt with AFIB / cardioembolic risks
hemorrhagic stroke

24
Q

Non cardioembolic stroke 1st line agents

A

ASA or Aggrenox
clopidogrel
for the first 21 days then ASA alone

25
What does dipyridamole do?
MOA - PDE inhibitor poor absorption from regular dosage forms BID
26
Role of DAPT after stroke used in
non disabling stroke high risk TIA
27
DVT/PE prophylaxis during a stroke
stroke pt are at risk for VTE due to paralysis all pt with reduced mobility are given preventative therapy
28
What are alternatives for DVT?
low dose heparin LMWH IPC or ES
29
What can DVT lead to?
pulmonary embolism
30
What is the first line BP control after a stroke?
ACE + TZD
31
What does the progress study show?
decrease the chances of a second stroke after ACEi and TZD
32
What are some secondary stroke prevention?
BP Antiplatelet therapy Cholesterol reduction smoking cessation
33
In the comparison between anticoagulants vs ASA in Non cardioembolic stroke what is the takeaways?
ASA vs warfarin Warfarin did not reduce events compared to ASA bleeding was also slightly higher in warfarin groups
34
What is the preferred therapy for atherosclerotic stroke management?
antiplatelet is preferred over anticoagulant warfarin is only recommended for cardioembolic stroke
35
What are the factors in the CHADS-65?
Heart Failure (CHF) hypertension age Diabetes stroke (prior)
36
What is done for everyone who have atrial fibrillation?
they will get stroke prevention even if they have never had a stroke
37
What the major catergories that are used in stroke management?
thrmbolysis (if pt fits criteria) antiplatelet therapy BP reduction Statins
38
What did the study show about taking ASA everyday?
it will reduce CV outcomes increase major bleeding it should only be used for secondary not primary prevention
39
What are the major risk for bleeding?
no previous history of bleeding no history of ulcers no anticoagulant therapy normal platelet level BP under control not frail