Stroke Flashcards
Define: Stroke, Ischaemic stroke, Hemorrhagic stroke and transient ischaemic stroke
Stroke: rapid death of brain tissue do to a disturbance in blood supply
Ischaemic stroke: Whereby there is a blockage of blood supply to the brain due to a blood clot
Hemorrhagic stroke: Whereby a blood vessel in the skull burst bleeds into the brain
Transient ischaemic stroke: whereby symptoms completely resolve within 24 hours
What are the different types of stoke
- Ischaemic stroke
- Herrmorhagic stroke
- Transient ischaemic stroke
What are the symptoms of stroke
(FAST): Facial weakness, Arm weakness, Speech problems
Lost of consciousness
Lost of coordination and balance
Severe headache
What is ABCD2, define acronym
To identify people at high risk of stoke after TIA
Age: 60 years of age or more = 1 point
Blood pressure: 140/90mmhg or greater at presentation= 1 point
Clinical features: unilateral weakness, speech disturbances without weakness= 1 point
Duration of symptoms: 10-59 mins= 1 point 60 mins or longer= 2 points
Diabetes= 1 point
What is the score criteria for ABCD2
ABCD2 high score= over 4
1. Aspirin 300mg start immediately
ABCD2 low score = under 4
no specific med specified
What is the pharmacological management of Ischaemic stroke
- Alteplase 900mcg/Kg/min
Cardioembolic ischaemic stroke (AF related) - Aspirin 300mg orally for 14 days (consider rectal if dysphagia)
- Followed by DOAC/ Warfarin as per DOAC team/ stroke physician
Severe ischaemic stroke (not AF related) - Aspirin 300mg orally 14 days (consider rectal if dysphagia)
- Followed by clopidogrel 75mg- Long term (Aspirin 75mg if intolerant)
What is the dose,drug class and mechanism of action for Alteplase (to treat TIA)
Dose: 900mcg/Kg/Min
Drug Class: Tissue Plasminogen Activator
Mechanism of action: Binds to fibrin in blood clots and converts plasminogen to plasmin. This leads to the dissolution of blood clots and the restoration of blood flow
What is the drug class and mechanism of action for dipyridimole ?- when would you use this drug
Drug class= Antiplatelet drugs/ Platelet aggregation inhibitors
Mechanism of action: inhibits the uptake of adenosine into the platelets which prevents platelet aggregation and therefore blood clots.
DO NOT REVISE THIS
What is peripheral arterial disease
Atherosclerotic plaques in the extremities
What are the symptoms of PAD
- None at first
- Coolness to touch
- Poor skin and nail health
- Infections/ Injuries dont heal
- Pain while walking, stops with rest
6.Discolouration: Pale, blue, dark red
How would you manage PAD
- Medication for hypertension, hyperlipidaemia
2.
What is the drug class and mechanism of action for naftidrofuryl oxalate
Drug class: peripheral vasodilators
Mechanism of action: dilates blood vessels
What is deep vein thrombosis and what are the symptoms
DVT= blood clot in one of the deep veins
Symptoms:
1. Sometimes asymptomatic
2. Pain, tenderness and swelling in one of the leg
3. Heavy pain in the affected area
4. Warm skin in the area of the clot
5. Redness of the skin at the back of the leg and below the knee
Name the treatment options for DVT
1.Heparin
2. Warfarin Sodium
3. Rivaroxaban
4. Apixaban
What is the drug class and mechanism of action for heparin
Drug Class: Heparin/ Anticoagulants
Mechanism of action: Enhances the activity of antithrombin III which inactivates clotting factors and inhibits the formation of clots
