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701 > Stroke > Flashcards

Stroke Flashcards

1
Q

Which type of brain matter is harder to have ischemia due to micro-vessel branching?

A

Grey matter

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2
Q

What does carotid circulation supply?

A

Anterior, mid, posterior

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3
Q

What does vertebral basilar circulation supply?

A

Pons, medulla, midbrain

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4
Q

What is a lacunar stroke?

A

Small vessel infarct in the white matter of the brain

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5
Q

T/F: Your chances of having a stroke after a TIA is statistically the same as having a stroke after a stroke.

A

TRUE!

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6
Q

Name some treatable stroke risk factors

A
  1. HTN
  2. High cholesterol
  3. Heart disease (esp. afib)
  4. Diabetes
  5. Smoking
  6. Excessive alcohol
  7. Obesity
  8. Inactivity
  9. Carotid bruit
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7
Q

Name some untreatable stroke risk factors

A
  1. Age (>55)
  2. Sex (male>female)
  3. Race (Black, Hispanic)
  4. Prior stroke
  5. Hereditary
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8
Q

When is the only time you will see an anticoagulant used for stroke prevention?

A

Atrial fibrillation patients, bilateral shower of emboli present on MRI

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9
Q

MOA of clopidogrel/prasugrel/ticagrelor?

A

ADP receptor blockade (P2Y12)

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10
Q

MOA of ASA?

A

Inhibition of COX and thromboxane

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11
Q

MOA of dipyridamole?

A

Increase plasma adenosine, inhibit platelet phosphodiesterase

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12
Q

What is AGGRENOX?

A

Low dose aspirin + dipyridamole

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13
Q

Which antiplatelet agent acts reversibly?

A

Dipyridamole

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14
Q

T/F: Enteric-coated ASA decreases the risk of GI bleeds.

A

FALSE! It decreases GI discomfort

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15
Q

Which stroke prevention therapy is the most efficacious?

A

Trick question, there is no evidence that puts one treatment over the other.

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16
Q

What should NOT be used in migraine history?

A

Dipyridamole

17
Q

What should be avoided with GI issues (IBS, spastic colon)?

A

ASA

18
Q

What should not be used with CCBs?

A

Clopidogrel/Prasugrel (CYP interaction)

19
Q

Which drug does not need to be avoided in CYP3A4/CYP2C19 inhibition since it is NOT a prodrug?

A

Ticagrelor (Brillenta)

20
Q

Important information during acute stroke

A
  • Home meds
  • When onset of stroke was
  • When was the patient last seen NORMAL?
21
Q

tPA time window

A

<2 hours for reversible deficits
2-6 hours for incomplete recovery
>6 hours for little recovery

22
Q

tPA drug

A

Alteplase
- ICH concern
- 0.9 mg/kg, 10% given over 1 minute bolus
- Keep BP <180 mmHg systolic for 24 hours

23
Q

tPA requirements

A
  • Ischemic stroke causing deficit
  • Symptom onset <4.5h (3h for 80+ y/o)
  • Age >18

701 (11 decks)

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