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3 Neurology > Stroke > Flashcards

Stroke Flashcards

1
Q

what conditions can mimic a stroke?

A 
seizure
sepsis
metabolic eg DKA
SOL
syncope
delirium
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2
Q

outline the components of the rosier score

A

loss of consciousness/syncope
seizure activity
acute onset: weakness, disturbance in vision/speech

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3
Q

when does a CT become ineffective at looking at blood and why?

A

1 week

blood reabsorbs so you cant see the white anymore

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4
Q

best imaging for blood after a week?

A

MRI

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5
Q

name the 4 different areas in which a stroke can occur?

A

posterior circulaion infarct
lacumar
total anterior circulation
partial anterior circulation

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6
Q

what does TACS mean in terms of stroke

A

total anterior circulation syndrome

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7
Q

how is a stroke named?

A

area it is PLUS whether it is a:
syndrome (s)
haemorrhage (h
infarct (i)

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8
Q

TACS presents with…

A

hemiplegia involving 2 of face, arm, leg
homonymous hemianopia
cortical signs

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9
Q

most severe type of stroke?

A

TACS

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10
Q

where are lacunar infarcts?

A

deep parts of the brain eg basal ganglia, white matter, thalamus. brain stem

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11
Q

what is a lacunar syndrome caused by

A

occlusion of a single deep penetrating artery

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12
Q

lacunar syndrome will affect what parts of the body?

A

face arm leg

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13
Q

what stroke has the best prognosis?

A

lacunar

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14
Q

how does the presentation of PACS differ from TACS?

A

has only a few of the features of TACS
motor/sensory signs
isolated cortical dysfunction

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15
Q

POCS wll present with…

A

cranial nerve palsyies
BILATERAL motor/sensory defects
homonymous hemianopia
blindness

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16
Q

a __ sided stroke will give you more disability after

A

left

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17
Q

what stroke type presents with bilateral motor and sensory signs

A

POCS

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18
Q

LHS brain is responsible for what functions

A

reasoning
spoken and written language
number skills

19
Q

what side of the brain is responsible for creativity, music, spacial orientation and artistic awareness?

A

RHS

20
Q

most common cause of stroke

A

atheroembolism usually from carotid

21
Q

a thrombus finally lodges in the ___ to cause an ischaemic stroke

A

cerebral

22
Q

Ix of stroke

A

angiogram

doppler USS carotid

23
Q

what autoimmune conditions can cause strokes?

A

vasculitis eg GPA, eGPA due to small vessel damage

24
Q

if a stroke patient has no risk factors and has a stroke, what could be the cause?

A

hereditary cerebral amyloid angiography

patent foramen ovale

25
Q

what does small vessel disease look like on MRI?

A

looks smudgy

26
Q

most common cardioembolic cause of stroke?

A

AF

27
Q

patient with recent MI who gets a stroke could have what cardioembolic causes?

A

ventricular thrombus

stasis from scar tissue

28
Q

what congenital defect can cause stroke and why?

A

patent foramen ovale

blood moves from R to L overloading the arterial side thus forming clots

29
Q

Tx of arterial dissection

A

anticoagulation and antiplatelets

30
Q

what is a carotid arterial dissection?

A

tear in the innermost lining of the carotid artery

31
Q

primary intracerebral haemotthage is caused by…

A

hypertension

amyloid angiography

32
Q

a secondary intracerebral haemorrhage is caused by…

A

patent foramen ovale
aneurysm
tumour

33
Q

a lobar primary intracerebral haemorrhage suggests what cause?

A

cerebral amyloid angiopathy

34
Q

hypertension is more likely to cause a haemorrhage where?

A

deep in the brain

35
Q

acute Tx of stroke

A 
thrombolysis/thrombectomy
imaging
swallow assessment
nutrition/hydration
antiplatelets
DVT prophylaxis
36
Q

thrombolysis only works if given before __ hours

A

4.5

37
Q

what problems would make thrombolysis less effective?

A 
diabetic patient
hypertensive patient
previous stroke
time since stroke onset
age
38
Q

outline the FAST mnemonic for stroke symptoms

A

facial weakness - can they smile? drooping?
arm weakness- can they raise both arms?
speech problems- can they speak and understand you?
test all 3

39
Q

if blood is not present on the CT due to hyperacuteness, how else could you diagnose a stroke using imaging?

A

look for a hyper-dense middle cerebral artery

40
Q

how does thrombectomy work?

A

put a wire into the area of the clot and catch it using a stent, pull it out

41
Q

name the 3 main subtypes of stroke causes

A

cardioembolic
atheroembolic
small vessel disease

42
Q

Ix for stroke

A 
lipid profile
BP
carotid scan 
ECG
ECHO if cardioembolic
43
Q

ABCD of stroke prevention?

A 
antithrombotics 
blood pressure
cholesterol
diabetes
dont smoke
44
Q

main carotid surgery performed on stroke patients?

A

carotid endarterectomy

3 Neurology (41 decks)

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