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Systems 1 > Stroke > Flashcards

Stroke Flashcards

1
Q

What are the two main types of stroke?

A

Infarct

Haemorrhagic

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2
Q

What is the biggest cause of ischaemic strokes?

A

Large artery atherosclerosis (common carotid)

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3
Q

What are the biggest causes of cardioembolic stroke?

A 
Infective material (infective endocarditis)
Atrial Fibrillation
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4
Q

What are the 4 stroke subtypes? What are their occurrence rates?

A

Total Anterior Circulation (20%)
Partial Anterior Circulation (35%)
Lacunar (20%)
Posterior Circulation (25%)

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5
Q

What is the % risk of stroke reoccurence?

A

14%

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6
Q

What proportion of TIA patients have another stroke?

A

1/3

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7
Q

What are the symptoms of stroke?

A

RAPID ONSET:

Loss of Power, Speech, Sensation, vision, coordination

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8
Q

What is the expected history of symptoms?

A

Time of onset and duration
Loss of consciousness
Fit
Incontinence

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9
Q

Which factors suggest haemorrhage?

A

Headache
Vomiting
Stiffness
Photophobia

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10
Q

What are the non modifiable risk factors for stroke?

A

Age
Race
Family history

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11
Q

What investigations would you take for a suspected stroke?

A 
Bloods: FBC, Lipids
ECG
CT
MRI
Carotid doppler
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12
Q

If the onset of neurological deficit was less than 4.5 hours ago, what is the first thing you do?

A

CT

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13
Q

What will be detected on examination?

A

Loss in motor/sensory/speech function
Neglect
Ataxia
Vertigo

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14
Q

Which arteries are involved with a LAC stroke?

A

Lenticulostriate arteries

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15
Q

What does a stroke presenting with Horner’s Syndrome and pain suggest?

A

Carotid dissection

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16
Q

What can signs and symptoms tell you about the stroke?

A 
Side
Brainstem
Cortex
Deep
Which blood vessel
17
Q

What are the modifiable risk factors for stroke?

A

Hypertension

Atrial fibrillation

18
Q

What is the common presentation of a TACS? What is the common cause?

A

Weakness, sensory deficit
Homonymous hemianopia
Higher cerebral dysfunction

Occlusion of proximal MCA/ICA

19
Q

What is the common presentation of a PACS?

A

2/3 of TACS presentation

20
Q

What is the most common form of LACS?

A

Pure motor (1/2 side of body)

21
Q

In which way is an MRI superior to a CT for stroke?

A

MRI better at showing ischaemic strokes

22
Q

What the requirement for thrombolytic treatment after stroke?

A

<4.5hrs

rt-PA

23
Q

What are the contraindications for thrombolytics?

A

Age

Recent MI

24
Q

When is a hemicraniectomy suggested for stroke?

A

Patient <60
Massive cerebral oedema
Within 48hrs

25
Q

What drugs are recommended for secondary prevention of stroke?

A

Clopidogrel
Statin
Blood pressure drugs (even if normal)

26
Q

What surgery is offered for carotid stenosis and when?

A

Carotid endarterectomy
>70% occlusion
Stroke with good recovery

Systems 1 (25 decks)

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