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Cardiology > Stroke > Flashcards

Stroke Flashcards

1
Q

What does focal neurological symptoms refer to?

A

The signs ans symptoms can tell you which part of the brain is affected

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2
Q

What is the definition of a stroke?

A

Acute onset of focal neurological symptoms and signs due to disruption of blood supply

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3
Q

What is the incidence rate of strokes?

A

4th commonest cause of death in Uk and third biggest in Scotland

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4
Q

What are the two types of stroke?

A

-haemorrhagic and ischemic

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5
Q

What causes an ischemic stroke?

A

blockage of an artery in the brain

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6
Q

What causes a haemorrhagic stroke?

A

blood vessel tears and bleeds into the brain causing damage and associated ischemic damage due to lack of blood flow to other areas

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7
Q

What is the most common type of stoke?

A

Ischaemic

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8
Q

What is the most common cause of haemorrhagic and ischemic stroke?

A

-high BP

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9
Q

What can cause haemorrhagic stroke?

A
  • high BP
  • weakened blood vessel wall due to
  • aneurysm, inflammation etc
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10
Q

What are the types of ischemic stroke?

A
  • thrombotic
  • embolic
  • hypoperfusion
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11
Q

What causes a hypoperfusion stroke?

A

reduced flow of blood due to stenosed artery rather than occlusion of artery

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12
Q

What are the risk factors for strokes?

A
  • older age
  • family history of CVD
  • Male
  • Race ie south Asian
  • previous stroke
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13
Q

Why is the age of stroke diagnosis decreasing?

A

Due to modifiable risk factors such as smoking and drinking

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14
Q

What are the modifiable risk factors for stroke?

A
  • hypertension
  • smoking
  • lack of exercise
  • diabetes
  • alcohol
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15
Q

What type of stroke does high cholesterol cause?

A

ischemic stroke

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16
Q

What is an example of a rare cause of stroke?

A

-protein S,C Antithrombin III deficiency

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17
Q

What is the treatment for acute presentation of stroke?

A

Thrombolysis or Thrombectomy

18
Q

How can the next stoke be avoided?

A

By identifying the cause of the stoke and starting appropriate treatment

19
Q

What are stroke mimics?

A

conditions that present acutely with focal neurological signs but are not due to interrupted blood flow

20
Q

What conditions cause stroke mimics?

A
  • hypoglycaemia
  • seizure
  • migraine
  • other metabolic
  • lesions ie tumour
  • functional hemiparesis
21
Q

How to determine the type of stroke?

A

Brian imaging such as

-CT or MRI with or without contrast

22
Q

What investigations could be carried out to discover the cause of ischemic stroke?

A
  • blood tests (glucose, lipids, thrombophilia)
  • BP
  • ECG
23
Q

What is an atheroembolism?

A

embolism from a thrombus forming on an atherosclerotic plaque on an artery

24
Q

What is a cardioembolism?

A

embolism from a clot formed in the heart (usually left atrium)

25
Q

What part of the brain will be affected by an atheroembolism?

A

the same side as the affected carotid artery

26
Q

What part of the brain will be affected by a cardioembolism?

A

will affect more than one arterial territory

27
Q

If bleed is deep whats the most likely cause of a haemorrhagic stroke?

A

hypertension

28
Q

If bleed is superficial what is the most likely cause of a haemorrhagic stroke?

A

aneurysm

29
Q

If there are multiple bleeds what conditions could you expect to cause haemorrhagic strokes?

A
  • vasculitis
  • Moya Moya disease
  • cerebal amyloid angiopathy
30
Q

How late after onset of symptoms can you do thrombolysis?

A

up to 4.5 hours

31
Q

How late after onset of symptoms can you do thrombectomy?

A

up to 6 hours

32
Q

What is an example of a thrombolytic drug?

A

t-PA

33
Q

How is t-PA administered?

A

IV

34
Q

How does a thrombectomy work?

A

-mesh around the clot and then pull it out

35
Q

When is a thrombectomy used?

A

in patients where the catheter can reach the clot ie in more proximal areas in small arteries not distal

36
Q

If the stroke was atheroembolic or due to a thrombus, what treatment should be given to prevent the next stroke?

A
  • antiplatelet
  • statins
  • diabetes management
  • hypertension management
  • lifestyle advice
37
Q

What is the antiplatelet treatment for prevention of next stroke?

A 
-aspirin 75mg 
AND
-Dipyridamol MR 200mg twice daily
OR
-Clopidogrel 75mg daily
38
Q

If the stroke was due to AF, what treatment should be given to prevent the next stroke

A
  • warfarin
  • oral anticoagulants ie rivaroxaban, dabigatran, etc
  • antihypertensives
39
Q

When is surgery indicated?

A

dead part of brain swells and can affect the normal part of brain due to compression within skull- surgeons may open cranium to allow swelling out of compressed area to save life

40
Q

What is a TIA?

A

Temporary neurological symptoms due to occlusion of artery stopping flow of blood

41
Q

Why is a TIA temporary?

A

arteries are capable of dissolving small clots

Cardiology (32 decks)

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