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Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a subarachnoid hemorrhage SAH)?

A

Blood enters the subarachnoid space

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2
Q

What causes an SAH?

A

Trauma
Intracranial aneurysm rupture
Arteriovenous malformations

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3
Q

What are the types of ischemic strokes?

A

Non-cardioembolic (local thrombus formation)

Cardioembolic (cardiogenic embolism)

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4
Q

What is a non-cardioembolic strokes d/t?

A

Plaques

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5
Q

What is a cardioembolic stroke d/t?

A

Stasis of blood in the atria/ventricles

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6
Q

What is a hemorrhagic stroke?

A

Blood in the brain parenchyma

Increased ICP

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7
Q

What are the RFs for ischemic stroke?

A 
Age >55
Race > AA, pacific islanders, Hisp
Men
FH stroke/TIA
Smoking
Obesity
HTN
DM
AFib
Dyslipidemia
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8
Q

What are the most common causes of hemorrhagic stroke?

A 
Trauma
Uncontrolled HTN
Antithrombotic therapy
Aneurysm
Arteriovenous malformations
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9
Q

What are the warning signs of a stroke?

A 
Sudden numbness/weakness of the face/arm/leg
Sudden confusion
Trouble speaking/understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking
Dizziness
Loss of balance or coordination
Sudden, severe HA with no known cause
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10
Q

What is the gold standard for diagnostic tests for stroke?

A

Non-contrast enhanced CT/MRI

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11
Q

How do we treat fever in strokes?

A

Antipyretics

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12
Q

How do we treat hyperglycemia?

A

Maintain glucose 140-180

Manage with IV insulin

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13
Q

When is HTN treatment recommended in stroke/

A

> 220/120

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14
Q

What antihypertensives are used in stroke?

A

Nicardipine
Labetalol
Hydralazine

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15
Q

What BP are required for t-PA?

A

<185/110

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16
Q

Within how many hours can alteplase be administered?

A

4.5 hours

Best results w/in 60 min - 180 min

17
Q

What is the t-PA dose?

A

0.9 mg/kg over 1 hr with 10% given over 1 minute

18
Q

What is the exclusion criteria for 3-4.5 hour use of t-PA?

A

> 80 yo
On oral anticoags
NIH stroke scale > 25
Hx of stroke AND dm

19
Q

What is the treatment of hemorrhagic stroke?

A

Supportive care
BP control (MAP < 130)
Management of ICP

20
Q

How do we control BP in hemorrhagic stroke?

A

Nicardipine
Labetalol
Esmolol

21
Q

How do we manage ICP?

A

Mannitol

22
Q

Who receives nimodipine?

A

Most subarachnoid hemorrhage patients

23
Q

What is the dose of nimodipine?

A

60mg PO q4h x 21 days

24
Q

What are the High intensity statins?

A

Atorv. 40-80

Rosuv 20-40

25
Q

What are alternatives to statins?

A

Zetia

PCSK9 inhibitor

26
Q

What does the CHA2DS2-VASc score stand for?

A 
CHF
HTN
2Age 75+
DN
2Stroke/TIA/thromboembolism
Vascular dz
Age up to 74
Female
27
Q

What is the treatment with a chadsvasc of 0?

A

No therapy or ASA

28
Q

What is the treatment with a chadsvasc of 1?

A

OAC or ASA

29
Q

What is the treatment with a chadsvasc of 2+?

A

OAC

Neuro (13 decks)

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