stroke Flashcards

1
Q

what is a stroke?

A

It is an acute onset of focal neurological symptoms and signs due to disruption of blood supply.

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2
Q

what are the two types of stroke?

A

haemorrhagic

- ischaemic - more common

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3
Q

what normally causes haemorrhagic stroke ?

A
  • hypertension
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4
Q

what does hypertension do to the vessel walls ?

A

it weakens it

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5
Q

what can weaken the vessel walls?

A

structural abnormalities like aneurysm, arteriovenous malformation

inflammation of the vessel wall (vasculitis

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6
Q

As you get older blood vessels become less ____ and so may be unable to cope with high ___

A

As you get older blood vessels become less elastic and so may be unable to cope with high blood pressure

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7
Q

ischaemic stroke can be due to

A
  • thrombus
  • embolus
  • hypoperfusion
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8
Q

what are some non-modifiable risk factors for stroke?

A
  • age - biggest one
  • family history
  • gender
  • race
  • previous stroke
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9
Q

what are some potentially modifiable risk factors? main ones

A
  • hypertension - systolic
  • history of TIA
  • hyperlipidaemia
  • smoking
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10
Q

what are some potentially modifiable risk factors? other ones

A
  • Diabetes
  • Atrial fibrilation
  • Congestive heart failure
  • Alcohol excess
  • Obesity
  • Physical inactivity
  • Poor socioeconomic status
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11
Q

what are some non-cardiac causes of stroke?

A
  • small vessel occlusion
  • cardiac emboli
  • atheroembolism
  • ## CNS bleeds
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12
Q

what are some cardiac causes of stroke ?

A
  • cardiac emboli
  • Non valvular AF
  • external cardioversion
  • prosthetic valves
  • acute MI
  • paradoxical systemic emboli
  • cardiac surgery
    Valve vegetations from SBE/IE
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13
Q

how can prosthetic valves cause emboli?stroke

A

risk of emboli

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14
Q

how can MI cause stroke?

A

large left ventricle wall motion abnormalities on echocardiography predispose to left ventricular thrombus.

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15
Q

what are some other causes of stroke ?

A
  • Homocysteinemia
  • Vasculitis, Antiphospholipid antibody syndrome
  • Protein S, C, Antithrombin III deficiency
  • Paradoxical embolism through patent foramen ovale/pulmonary AV shunts
  • Genetic- Factor V Leiden mutation, common prothrombin mutation, MELAS, -CADASIL,Fabry’s disease
  • Cardioembolic- mural thrombi, infective endocarditis, myxoma
  • Cervical artery dissection
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16
Q

what is a TIA?

A

essentially it is the same as a stroke

17
Q

Blood vessels are built in such a way so that they can deal with a clot - every blood vessel has ____ (i think this is capable of breaking down clots)

A

tpa

18
Q

If you have a small clot in the vessels this may be enough to cause symptoms (____) but the enzyme will eat away at it

A

If you have a small clot in the vessels this may be enough to cause symptoms (TIA) but the enzyme will eat away at it

19
Q

what are the 6 essential questions for stroke?

A

1) Is this a stroke ?
2) What kind of stroke is this ?
3) What caused this stroke/TIA?
4) Have I tried my best to answer question 3 ?
5) Is the patients on the appropriate secondary prevention following investigations
6) Have I answered any questions the patient has ?