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Y3 AGEING > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a stroke?

A

Rapid decline in cerebral function due to inadequate blood supply + focal, and at times global signs lasting more than 24 hours

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2
Q

What is the difference between a TIA and stroke?

A

TIA is a short episode (less than 24hrs) caused by focal brain or retinal ischaemia with no evidence of acute infarction
INCREASED RISK OF STROKE IN NEXT WEEK

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3
Q

What are the 3 main types of stroke, and how common are they?

A

Haemorrhagic (10%)
Sub-arachnoid haemorrhage (5%)
Ischaemic (infarct) (85%)

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4
Q

What is usually the cause of haemorrhagic stroke?

A

Structural abnormality due to hypertension

Or amyloid angiopathy (protein deposits in brain with ageing, leading to degeneration)

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5
Q

What are usually the causes of ischaemic stroke?

A

Atherothrombosis (platelet dependant white thrombus)
Small vessel disease
Cardioembolic (fibrin dependant red thrombus)

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6
Q

List the main functions of the frontal lobe of the brain

A

Personality
Emotional response
Social behaviour

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7
Q

Which imaging is used to find the presence of a cerebral infarct or haemorrhage?

A 
CT scan (good for haemorrhages)
MRI (often needed to identify infarcts)
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8
Q

List supportive imaging that can help investigate aetiology of a stroke

A

Carotid scan
Angiogram
ECG (?AF)/ 24hr tape
Echocardiograph

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9
Q

What scale can be used for diagnosis of a stroke? What are the + signs and what are the -?

A

Rosier scale

Asymmetric facial/arm/leg weakness
Speech disturbance
Visual field defect

Loss of consciousness/syncope/ seizure activity

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10
Q

What would hypo- vs hyperattenuation suggest on a CT of the brain?

A

HYPO: Haemorrhage = white
HYPER: Infarct = dark (represents oedemous inflammatory response - water)

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11
Q

What surgical options are available for the treatment of stroke?

A 
Thrombolysis/thrombectomy (within first four hours of an infarct)
Carotid endarterectomy (atherosclerosis of carotid arteries)
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12
Q

What is involved in the acute management of stroke?

A

Antiplatelets
DVT prophylaxis
Dysphagia management/ swallow screen
Nutrition and hydration

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13
Q

What tool is used to screen for risk of malnutrition on admission?

A

MUST screen

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14
Q

Why is a swallow screen so important after a stroke?

A

Avoid aspiration of material into airway

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15
Q

What is the 1st line antiplatelet prescribed in stroke? What must be done first before prescribing?

A

Aspirin 300mg

CT (to exclude bleed)

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16
Q

What are the main methods of DVT prophylaxis?

A

Heparin (can increase bleeding risk)
TED stockings
Intermittent pneumatic compression

17
Q

What are the main risk factors that need to be considered in stroke?

A 
High cholesterol
BP
DM
Smoking
AGE
CHF/ CHD
Previous stroke/ TIA/ VTE
Female
18
Q

Anticoagulants are prescribed if not cardioembolic in secondary prevention of stroke. True/ False?
Give an example

A

False
If it is cardioembolic/ AF
Warfarin or NOAC (1st line = edoxiban) 10 days after

19
Q

What medications are prescribed in secondary prevention of stroke with no cardioembolic cause?

A

Aspirin +
1st line = clopidogrel
2nd line = dysprimadole

20
Q

What other medications may need to be prescribed in secondary prevention of stroke?

A

Statins

Anti-hypertensives

21
Q

How can AF cause strokes?

A

Irregular heart beating causes blood to be whipped up and clots can be fired to brain

22
Q

What score can be used to assess the risk of a stroke if you have AF?

A

CHA2DS2VASC Score

23
Q

What score can be used to assess a person’s bleeding risk of they have AF?

A

HAS-BLED score (risk of anticoagulation)

24
Q

What lifestyle advice can be given regarding stroke management?

A 
5 or more fruit/veg per day
2 x oily fish per week
Exercise
Reduce salt intake 
14 units max a week of alcohol
Reduce sat fats and increase poly/monounsaturated fats
25
Q

What type of stroke, using Oxford classification has the poorest prognosis?

A

TACI

26
Q

What type of diet should be recommended for stroke patients?

A

Mediterranean diet

Y3 AGEING (8 decks)

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