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Conditions: Cardiovascular > Stroke > Flashcards

Stroke Flashcards

1
Q

What is the definition of stroke?

A
  • Neurological deficit of sudden onset lasting for more than 24 hours
  • Vascular origin
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2
Q

What does TIA stand for?

A
  • Transient ischaemic attack
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3
Q

What is a TIA?

A
  • A stroke resulting in a neurological deficit of less than 24 hours
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4
Q

What are the 4 subtypes of stroke?

A
  • TACS
  • PACS
  • LACS
  • POCS
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5
Q

What does TACS stand for?

A
  • Total anterior circulation stroke
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6
Q

What percentage of strokes are TACS?

A
  • 20%
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7
Q

What is the mortality of TACS?

A
  • The worst of the 4
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8
Q

What does PACS stand for?

A
  • Partial anterior circulation stroke
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9
Q

What percentage of strokes are PACS?

A
  • 35%
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10
Q

What does LACS stand for?

A
  • Lacunar stroke
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11
Q

What percentage of strokes are LACS?

A
  • 20%
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12
Q

What does POCS stand for?

A
  • Posterior circulation stroke
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13
Q

What percentage of strokes are POCS?

A
  • 25%
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14
Q

What is special about POCS?

A
  • Highest recurrence rate
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15
Q

What do the symptoms of stroke depend on?

A
  • The area of the brain affected
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16
Q

What are the 5 things that can be lost due to a stroke?

A
  • Power
  • Sensation
  • Speech
  • Vision
  • Coordination
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17
Q

How can power be lost?

A
  • Loss of motor control
  • Clumsiness
  • Weak limb
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18
Q

How can sensation be lost?

A
  • Loss of feeling in areas of the body
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19
Q

What 2 ways can throat function be affected?

A
  • Dysarthria (slurred speech)

- Dysphagia

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20
Q

What ways can visual function be affected?

A
  • Visuospatial problems
  • One eye affected
  • Hemianopia
  • Gaze palsy
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21
Q

What is hemianopia?

A
  • Blindness over half the field of vision
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22
Q

What is gaze palsy?

A
  • Inability to move the eyes in the same direction of motion
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23
Q

What 4 conditions can coordination be affected due to?

A
  • Ataxia
  • Vertigo
  • Incoordination
  • Nystagmus
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24
Q

What is ataxia?

A
  • Loss of voluntary function
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25
Q

What is nystagmus?

A

Constant uncontrolled eye movements

26
Q

What modifiable risk factors are there for stroke?

A
  • Hypertension

- AF (loss of adequate blood flow to the brain)

27
Q

What are the non modifiable risk factors for strokes?

A
  • Age
  • Race
  • Family history
28
Q

What is the cause of stroke?

A
  • Damage to part of the brain due to blockage of a blood vessel by thrombus or embolism OR
  • Haemorrhage from a ruptured blood vessel
29
Q

What percentage of strokes are caused by infarction?

A
  • 85%
30
Q

What are the 5 ways that infarction can occur in vessels in the brain?

A
  • Large artery atherosclerosis
  • Cardioembolic stroke
  • Small artery occlusion
  • Undetermind/cryptogenic
  • Rare causes
31
Q

What percentage of infarcting strokes are caused by large artery atherosclerosis?

A
  • 35%
32
Q

What large artery is usually the one to cause an infarction due to it having atheromatous plaques and what do these plaques do to the artery?

A
  • Carotid artery

- Cause carotid stenosis which will be heard as a bruit on examination

33
Q

What is a cardioembolic stroke a result of?

A
  • AF
34
Q

What percentage of infarcting strokes are cardioembolic strokes?

A
  • 25%
35
Q

What type of stroke is a result from small artery occlusion?

A

Lacunar

36
Q

What percentage of infarcting strokes are from small artery occlusion?

A
  • 25%
37
Q

What percentage of infarcting strokes are from undetermined/cryptogenic causes?

A
  • 10 - 15%
38
Q

What rare causes may result in a stroke?

A
  • Aortic dissection

- Venous sinus thrombosis

39
Q

What percentage of strokes are from haemorrhage?

A
  • 15%
40
Q

What is the main cause of haemorrhagic stroke?

A
  • Primary intracerebral haemorrhage
41
Q

What is a primary intracerebral haemorrhage?

A
  • A bleed in the brain tissue
42
Q

What pathologies can cause a primary intracerebral haemorrhage?

A
  • Brain trauma
  • Aneurysm
  • Tumours
43
Q

What type of haemorrhages account for the other 30% of haemorrhagic stroke?

A
  • Subarachnoid

- Arteriovenous malformations

44
Q

What initial tests should be carried out on presentation of a suspected stroke?

A
  • Blood tests
  • ECG
  • CT scan
  • MRI
  • Carotid doppler
  • Echocardiogram
45
Q

What blood tests should be carried out?

A
  • FBC (platelets and RBC’s)
  • Lipid count
  • ESR
46
Q

What is the benefit of a CT scan?

A
  • Quick

- Shows the area of the infarct

47
Q

What are the benefits of an MRI?

A
  • Better for ischaemic stroke diagnosis
48
Q

What are the detriments of MRI?

A
  • Takes longer

- Claustrophobic

49
Q

Why is an echocardiogram used in stroke diagnosis?

A
  • Look for clots in the heart
50
Q

What unit should the patient be referred to after diagnosis?

A
  • Stroke unit
51
Q

What things should be done in the stroke unit?

A
  • Mobility

- Concentrate on simple things for the patient such as swallowing and positioning

52
Q

What treatment should be performed in the stroke unit?

A
  • Anti coagulation
53
Q

What initial treatment should be done to reduce effects of a stroke?

A
  • THROMBOLYSIS

- Clot retrieval using minimally invasive surgery

54
Q

What is the aim of thrombolysis?

A
  • Restore perfusion before cell death occurs
55
Q

What drugs are used in thrombolysis?

A
  • Alteplase
  • Reteplase
  • Tenecteplase
56
Q

What type of drug are all alteplase, reteplase and tenecteplase?

A
  • Tissue plasminogen activators
57
Q

What do tissue plasminogen activators do?

A

Convert plasminogen to plasmin to break down clot

58
Q

At what time do risks of thrombolysis outweigh the benefits?

A
  • Around 4.5 hours after event
59
Q

How is minimally invasive clot retrieval surgery performed?

A
  • Catherter with a retrieval device on the end
60
Q

What is the typical history of presenting complaint of a stroke?

A
  • Headache
  • Vomiting
  • Neck stiffness
  • Photophobia
  • Loss of consciousness
  • Fit
  • Incontinence
61
Q

What does photophobia suggest?

A
  • The stroke is haemorrhagic
62
Q

What does post thrombolysis haemorrhage risk depend on?

A
  • Infarct size
  • Vessel occlusion
  • Diabetes
  • BP
  • Age

Conditions: Cardiovascular (25 decks)

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