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Geriatrics > Stroke > Flashcards

Stroke Flashcards

1
Q

How are strokes scored?

A

National institute of health stroke scale

Normal = 0

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2
Q

What are the commonest source of emboli for ischaemic stroke?

A

Heart and carotid artery

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3
Q

What are some exclusion criteria for thrombolysis?

A

Recent trauma or surgery
Aortic dissection
INR over 1.4
Pregnant

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4
Q

What are some inclusion criteria for thrombolysis?

A

Symptom onset in last 4.5 hours
Measurable deficit on NIHSS
No haemorrhage on CT

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5
Q

What are the risks of thrombolysis?

A

Haemorrhage

Angioedema

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6
Q

What are some stroke mimics?

A

Seizures
Sepsis
Hypoglycaemia
Migraine

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7
Q

Which arteries does TACS affect?

A

Middle and anterior cerebral arteries

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8
Q

What are the criteria for TACS?

A

All 3 of:

  1. Unilateral weakness of face, arm or leg
  2. Homonymous hemianopia
  3. Higher cerebral dysfunction
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9
Q

What are the criteria for PACS?

A

2 of:

  1. Unilateral weakness
  2. Homonymous hemianopia
  3. Higher cerebral dysfunction
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10
Q

Which arteries does POCS affect?

A

Posterior circulation

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11
Q

What are the criteria for POCS?

A

1 of:

  1. Cerebellar/brainstem syndromes
  2. Loss of consciousness
  3. Isolated homonymous hemianopia
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12
Q

What are the criteria for LACS?

A

1 of:

  1. Unilateral weakness
  2. Pure sensory stroke
  3. Ataxic hemiparesis
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13
Q

What is the definition of a TIA?

A

Sudden onset of neurological symptoms lasting less than 24 hours

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14
Q

What are crescendo TIAs?

A

2 or more within a week - high risk of stroke

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15
Q

What is the ABCD2 score used for?

A

Gives risk of stroke in next 48 hours

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16
Q

What are the criteria on abcd2?

A

Age over 60
BP over 140/90
Clinical - unilateral weakness, speech disturbance (2 points)
Duration - over 60 mins = 2, 10-59 mins = 1
Diabetes

17
Q

What should be done in the community after a suspected TIA?

A

Give aspirin 300mg
Tell not to drive for 1 month
Arrange appointment at TIA clinic within 1 week

18
Q

What tests should be done after a TIA?

A 
Height, weight and BMI 
FBC, U&Es, LFTs, lipids 
Carotid artery US Doppler 
Blood glucose
ECG - if AF do chads2vasc score
19
Q

How should carotid stenosis be treated?

A 
Over 70% - surgery within 2 weeks
BP control
Antiplatelets
Statins 
Diet advice
20
Q

What are primary prevention risk factors for ischaemic stroke/TIA?

A

Diabetes
Hypertension
Smoking
Hyperlipidaemia

21
Q

What are secondary prevention risk factors for ischaemic stroke/TIA?

A

Prior event
CAD/PVD
Carotid stenosis
AF

22
Q

What are risk factors for haemorrhagic stroke?

A 
Hypertension 
Cerebral amyloid angioplasty
Aneurysms 
Cerebral arteriovenous malformations 
Brain tumours
23
Q

What are some complications of stroke?

A

Aspiration pneumonia

Brain haemorrhage

24
Q

When is decompressive hemicraniotomy indicated?

A 
MCA infarct
Under 60 years 
NIHSS over 15 
Reduced GCS 
CT shows infarct over 50% MCA territory

Geriatrics (8 decks)

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