Stroke Flashcards
define stroke
rapidly developing symptoms/signs of loss of brain function with symptoms lasting over 24hrs
strokes cause pain in their early stages T or F
F
Hx q’s for stroke
time of onset symptoms before and now progression
what symptoms would indicate an acute onset of stroke?
asymmetric facial/arm/leg weakness speech disturbance visual field defect
stroke is not a diagnosis T or F
T
2 main types of stroke
haemorrhage infarct
4 main causes of infarct stroke
atheroembolic small vessel cardioembolic (clots from heart) other
most common main type of stroke
infarct
3 causes of haemorrhagic stroke?
structural abnormality eg tumour hypertensive amyloid angiopathy
what conditions can cause small vessel infarct stroke
diabetes CVD cholesterol
you can differentiate between a haemorrhagic or infarct stroke T or F
F, need imaging
blood looks __ on imaging
white
how would you identify an infarct stroke on imaging
hypoattenuation (dark changes) appears swollen/smudgy
1st line imaging for a stroke
CT
define TIA
loss of brain function lasting <24hrs, usually only an hour
how would you assess TIA straight away
history carotid imaging ECG blood tests
why would you do carotid imaging in a suspected stroke/TIA?
see if they have carotid stenosis
why would you do blood tests in a suspected stroke/TIA
check cholesterol glucose for underlying diabetes
Tx for carotid stenosis
carotid endarterectomy
immediate drug management of stroke/TIA?
antiplatelets to stop thrombotic process statin
management of an acute stroke
thrombolysis/thrombectomy imaging swallow assessment (risk of aspirating) nutrition/hydration antiplatelets + statin if infarct DVT prevention
an infarct in the left side of the brain causes a __ sided weakness
right
where is the abnormality here?
what kind of stroke is it?
left side of the brain around the middle
ischaemic stroke
name the drug and dose used for antiplatelet cover in stroke
aspirin 300mg
why is CT done?
to exclude a bleed
if antiplatelets cannot be given PO, how should they be delivered?
NG tube first then PR if still cant
DVT prophylaxis
stockings (pneumatic compression)
LMWH
if swallow screen is abnormal what is then done
assessment by speech and language therapist
within what timeframe should a swallow screen be done?
4hrs of arrival
if patient can’t swallow what should be given
- NG tube
2, PEG tube
secondary prevention of stroke
lifestyle changes
rehab
carotid surgery
antiplatelets if not cardioembolic
statins
anticoagulants if cardioembolic
Ix for stroke
CT
MRI
carotid scan (only looks at neck)
angiogram
24hr ECG
ECHO
what colour is a fibrin dependent thrombus?
red
what colour is a platelet dependent thrombus?
white (plates are white)
a cardioembolic stroke is ___ dependent
an atheroembolic stroke is __ dependent
fibrin
platelet
is AF cardioembolic or atheroembolic
cardioembolic
AF raises risk of what type of stroke?
iscahemic
first line antiplatelet for non-acute stroke
clopidogrel
how can you work out someone’s stroke risk if they’ve got AF?
CHA2DS2VASC score
maximum CHA2DS2VASC score?
9
a patient with AF who gets a VASC score of 0 should be given prophylactic anticoagulation T or F
F
AF patient with 1 VASC risk factor should get aspirin T or F
F, OAC preferred eg apixaban
aspirin is as bad as warfarin for bleeding T or F
T
what drug should never be used to treat cardioembolic stroke?
aspirin!
worst type of stroke
total anterior circulation stroke
