Stroke

Question 1

What type of stroke causes a loss of focal cerebral or ocular function, with symptoms lasting less than 24 hours?

Answer 1

TIA

Question 2

What is classed as a normal stroke?

Answer 2

Ischaemic stroke

Question 3

What type of stroke causes damages deep cerebral tissue?

Answer 3

Intracerebral Haemorrhage (ICH)

Question 4

What type of stroke causes damage to the surface of the brain?

Answer 4

Subarachnoid Haemorrhage (SAH)

Question 5

What causes TIA?

Answer 5

-Atherosclerosis
-Cardiac or carotid emboli
-Arterial stenosis
-Hypercoagulable states
-Arterial dissections
-Vasoconstriction associated with substance misuse

Question 6

What causes Ischaemic stroke?

Answer 6

-Vessel occulsion
-Lifestyle
-HTN
-Cardiac disease
-Dyslipidaemia
-DM
-Migraine
-Age increase
-Male
-Family history
-Previous stroke/TIA
-Hyperocagulable
-Ethnicity
-Carotid artery stenosis

Question 7

What ethnicity increases the chance of having an Ischaemic stroke?

Answer 7

South Asian, African, Caribbean

Question 8

What causes ICH stroke?

Answer 8

-High bp
-Vessel abnormalities
-Bleeding disorders
-Vasculitis
-Amyloid angiopathy
-Arteriovenous malformations

Question 9

What causes SAH stroke?

Answer 9

-Aneurysm (Congenital or because of high bp)
-Arteriovenous malformations

Question 10

What is the acute treatment options for a TIA when symptoms have resolved and pt has no AF?

Answer 10

Aspirin 300mg OD STAT

Question 11

If pt has a minor stroke + TIA with no AF, what is the treatment?

Answer 11

Specialist within 24 hours of onset

Question 12

If a patient has a confirmed TIA, what treatment should be initated?

Answer 12

*Dual antiplatelet therapy + PPI
*Clopidogrel 300mg STAT
then 75mg OD long term
*Aspirin 300mg STAT then 75mg for 21 days

Or Ticagrelor 180mg STAT then 90mg BD
+
Aspirin 300mg STAT then 75mg for 30 days

Question 13

If a patient isn’t appropriate for dual antiplatelet therapy, what should be given to them?

Answer 13

Clopidogrel 300mg STAT followed by 75mg OD

Question 14

If a patient has a confirmed Ischaemic stroke, what should be given?

Answer 14

Thrombolysis within 4.5-9 hours of onset of action.
CLOT BUSTER such as Alteplase / Tenecteplase!

Question 15

Your patient 24 hours ago has a Ischaemic stroke, what would you expect them to be started on now?

Answer 15

Aspirin

Question 16

Your patient has had a confirmed Haemorrhagic stroke, what treatment would be given first?

Answer 16

*Aspirin 300mg OD for 2 weeks

Question 17

Your patient has a haemorrhagic stroke and has been on Aspirin 300mg for 2 weeks, what medication would you expect to see them started on now, considering they have AF?

Answer 17

DOAC or Warfarin long-term

Question 17

Your patient has a haemorrhagic stroke and has been on Aspirin 300mg for 2 weeks, what medication would you expect to see them started on now, considering they have don’t have AF?

Answer 17

Antithrombotic treatment
+PPI and Aspirin

Question 17

What is the BP target of someone who has had a stroke?

Answer 17

130/80

Question 18

What strength of statins would you expect to see if someone has had a stroke?

Answer 18

Atorvastatin 80mg

Question 19

Would you expect a patient with stroke symptoms to be eating and drinking?

Answer 19

NO NBM straight away!