Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N - C > Stroke > Flashcards

Stroke Flashcards

1
Q

75% of strokes occur in people of what age?

A

> 65 years old

Stroke risk increases with age

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

How many people die within 1 year of a stroke?

A

1/3

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

How many stroke survivors remain dependent on others for daily activities?

A

50%

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

What is stroke?

A

The SUDDEN onset of FOCAL or global neurological symptoms caused by ISCHAEMIA or HAEMORRHAGE and lasting more than 24 hours

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

What percentage of strokes are ischaemic?

A

85%

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

What is transient ischaemic attack (TIA)?

A

The term used if symptoms resolve within 24 hours

Most TIAs resolve within 1-60 min

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

What are the main causes of Ischaemic stroke?

A
  • Large artery atherosclerosis (e.g. Carotid) 35%
  • Cardioembolic (e.g. AF) 25%
  • Small artery occlusion (Lacune) 25%
  • Undetermined/Cryptogenic (10-15%)
  • Rare causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the main causes of Haemorrhagic stroke?

A

Primary intracerebral haemorrhage 70%

Secondary haemorrhage 30%

  • Subarachnoid haemorrhage
  • Arteriovenous malformation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe hypoxia to the brain

A

The failure of cerebral blood flow to a part of the brain

Caused by an interuption of the blood supply to the brain

Can be transient (as in TIA)

Results in varying degrees of hypoxia

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

What can hypoxia do to the brain?

A

Hypoxia stresses the brain cell metabolism. This is especially important in the ischaemic penumbra

If prolonged the hypoxia -> anoxia (no oxygen)

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

What does anoxia cause in brain tissue?

A

Anoxia -> infarction (complete cell death, leading to necrosis). This is a stroke

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

Apart from infarction how can further damage result during a stroke?

A

Oedema, depending on the size and location of the stroke

Secondary haemorrhage into the stroke

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

What are the non-modifiable risk factors for stroke?

A

Previous stroke
Being old
Being male
Having a horrible family history

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

What are the modifiable risk factors for a stroke?

A 
HYPERTENSION
Smoking
Cholesterol
Diet
High BMI
Sedentary lifestyle
Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is hypertension related to stroke?

A

Chronic hypertension worsens atheroma and affects small distal arteries

Both stroke and hypertension reach major proportions in the elderly

Hypertension is a major risk factor for haemorrhagic strokes as well

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

How is diabetes related to stroke?

A

Diabetes mellitus increases the incidence of strokes up to 3 fold in both sexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is smoking related to stroke?

A

Smokers have:

  • 2 fold increase of cerebral infarction
  • 3 fold increased risk of sub arachnoid haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How are lipids related to stroke?

A

Increased serum lipids increase stroke risk due to blood vessel wall atheroma

Increased plasma level of LDL results in excessive amounts of LDL within the arterial wall

Hypertension, cigarette smoke and diabetes contribute to LDL-C deposition in arterial walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does alcohol relate to stroke?

A

Small amounts of alcohol decrease stroke risk

Heavy drinking increases risk 2.5 fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does obesity relate to stroke?

A

(especially abdominal)

Recently identified as an independent risk factor for vascular disease including stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What other medical risk factors increase likelihood of stroke?

A

Impaired cardiac function (recent heart attack, AF)

Oral contraceptives (+ HRT) with a high estrogen content.
-Progesterone (only ok)

Hyper coagulable states

  • Malignancy
  • Genetic
22
Q

What forms the anterior circulation of the brain?

A

2 internal carotid arteries

  • 2 anterior cerebral arteries
  • 2 middle cerebral arteries
23
Q

What forms the posterior circulation of the brain?

A

2 vertebral arteries -> 1 basilar

  • 3 pairs of cerebellar arteries
  • 2 posterior cerebral arteries
24
Q

What are the symptoms of ACA occlusion?

A

Contra-lateral

  • Paralysis of foot and leg
  • Sensory loss over foot and leg
  • Impairment of gait and stance
25
Q

What are the symptoms of MCA occlusion?

A

Contra-lateral

  • Paralysis of face/arm/ (leg)
  • Sendory loss face/arm/ (leg)
  • Homonymous hemianopia

Gaze aralysis to the opposite side

Aphasia if stroke on dominant (left) side

Unilateral neglect and agnosia for half of external soace if non-dominant stroke (usually right side)

26
Q

What is included in Agnosias?

A

Agnosias = neglect syndromes

  • Visual agnosia
  • Sensory agnosia
  • Anosagnosia (denial of hemiplegia)
  • Prosopagnosia (failure to recognise faces)
27
Q

What strokes are most likely to affect basal banglia?

A

Lacunar strokes from the middle cerebral artery

28
Q

Describe Laclunar stroke syndromes

A

Devoid of “cortical” signs
-E.g no dysphasia, neglect, hemianopia

  1. Pure motor stroke
  2. Pure sensory stroke
  3. Dysarthria - clumsy hand syndrome
  4. Ataxic hemiparesis
29
Q

What anatomy is involved in posterior circulation symptoms?

A

Brain stem/ Cerebellum/ Thalamus

Occipital and medial temporal lobes

30
Q

What are the symptoms of brainstem dysfunction?

A
  • Coma, vertigo, nausea, vomiting, cranial nerve palsies, ataxia
  • Hemiparesis, hemisensory loss
  • Crossed sensory-motor deficits
  • Visual field defects
31
Q

What should acute ischaemic stroke therapies do?

A

Restore blood supply

Prevent extension of ischaemic damage

Protect vulnerable brain tissue

32
Q

Compare NNT of different stroke treatments

A

IV TPA

33
Q

What is TPA?

A

Tissue Plasminogen Activator

34
Q

What are the staffing components of a stroke unit?

A 
Clinical staff
Stroke nurses
Physiotherapists
Speech and language therapists
Occupational therapists
Dietitian
Psychologist
Orthoptist
35
Q

What is the OCSP Stroke classification?

A

Total Anterior Circulation Stroke (TACS)

Partial Anterior Circulation Stroke (PACS)

Lacunal Stroke (LACS)

Posterior Circulation Stroke (POCS)

36
Q

What is the strict criteria for TPA use?

A

60 minutes

Consent obtained

37
Q

What is the exclusion criteris for IV TPA?

A

Anything that increases the possibility of haemorrhage:

  • Blood on CT scan
  • Recent surgery
  • Recent episodes of bleeding
  • Coagulation problems

BP >185 systolic or >110 diastlic

Glucose 22mmol/L

38
Q

What is the stroke recurrence from TIAs?

A

10% stroke recurrence within first 2 weeks

39
Q

What treatments reduce the risk of stroke after a TIA?

A

Antiplatelets
Antihypertensives
Statins and Endarterectomy

40
Q

When searching for the aetiology for stroke what should you consider?

A

Atherosclerotic narrowing

Embolic - cardiac sourse (AF, recent MI)

Artery to artery embolism

Hypercoaguable state

Arterial dissection

Venous sinus thrombosis

41
Q

What investigations should you carry out for stroke?

A 
Routine blood tests
CT or MRI head scan
ECG
Echocardiagram
Carotid doppler ultrasound
Cerebral angiogram/ venogram
Hyper-coagulable blood screen
42
Q

What do you look for in routine blood tests for stroke?

A

FBC
Glucose
Lipids
ESR etc

43
Q

What can CT or MRI head scan show in stroke?

A

Infarct vs haemorrhage

44
Q

What can ECG show in stroke?

A

?AF

?LVH

45
Q

What can echocardiogram show in stroke?

A

Valves

ASD, VSD

46
Q

What can a carotid doppler ultrasound show in stroke?

A

?stenosis

47
Q

What can cerebral angiogram/ venogram show in stroke?

A

Vasculitis?

48
Q

What is the secondary prevention in stroke?

A 
Anti hypertensives 
Anti-platelets
Lipid lowering agents
Warfarin for AF
Carotid endeterectomy (NNT of 3)
49
Q

What should you always try to rule out in suspected stroke?

A 
Post-ictal states (e.g. Todd's paralysis)
Hypoglycemia
Intracranial masses
Vestibular disease
Bell's palsy
Functional hemiparesis
Migraine
Demented patients with UTIs
50
Q

After a stroke management should include…

A

Prevention of stroke recurrence

Prevention of complications related to stroke

Rehabilitation

Re-integration into the community

51
Q

What are the objectives of stroke care?

A

Reduce mortality

Reduce residual disability amongst survivors

Improve psychological status of patients and care-givers

Improve patient/ care giver knowledge

Maximise quality of life

N - C (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions