Stroke Flashcards

1
Q

what is stroke?

A
  • It is the destruction of a portion of the brain that is is a results of lack of circulation in speicifc vessels
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2
Q

What are the two types of strokes?

A
  • Ischeamic

- Herrmoharge

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3
Q

What are the two types of ischeamic stroke?

A
  • Thrombotic

- Embolic

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4
Q

what are the differences between thrombotic and embolic ischeamic stroke?

A

Thrombotic:

  • Caused by platelet aggregation
  • Onset is slow can occur during sleep
  • Risk factors include large vessles e.g atherosclerosis

Embolic:

  • Cuased by fragments formed outside the brain break and travel to vesles inside the brain
  • Onset is abrupt and can occur during execise
  • Risk factors include Afib or valve disease
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5
Q

What are the three types of hemorrhagic stroke?

A
  • Subarachnoid hemorrhage - bursting of aneurysm (less common)
  • Intracerebral hemorrhage - caused due to hypertension
  • Intraventricular hemorrhage - an extension of ICH
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6
Q

Bleeding around the brain is subarachnoid hemorrhage. TRUE OR FALSE?

A

TRUE

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7
Q

Bleeding inside brain is Intracerebral, intraventricular. TRUE OR FALSE?

A

TRUE

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8
Q

What are some symptoms of stroke?

A
  • Ataxia
  • Aphasia
  • facial drop
  • N&V
  • Dizziness
  • Confusion
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9
Q

What are the steps for acute managment of stroke?

A
  • Diagnosis of stroke
  • Define stroke type
  • Acute general medicines
  • Re-perfusion
  • Neuroprotection
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10
Q

Ischeamic region on a CT scan appears black due to oedema that has occured. true or flase?

A

true

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11
Q

Describe the pathology of ischemia?

A
  • Ischemia leads to energy deficit
  • Na+k+ channels fail to work
  • leads to oedema
  • Leads to narrowing of extracellular matrix
  • Leads to restricted diffusion of water within the cell
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12
Q

In the absence of blood flow, available energy can maitian neuronal viability for 2-3 minutes. TRUE OR FLASE/

A

TRUE

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13
Q

The penumbra is potentilly salvageabke with early recannalization. TRUE OR FALSE?

A

TRUE

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14
Q

The penumbra is salvageable due to the fact that it is hypoperfused due to collateral blood flow. TRUE OR FLASE?

A

TRUE

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15
Q

What does rt-PA stand for?

A
  • Recombinant thrombolysis plasminogen activator
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16
Q

What si the Mr of rt-PA?

A
  • 68,000 daltons
17
Q

rt-PA preferentially activates plasminogen bound to fibrin. TRUE OR FALSE?

18
Q

What is the mechanism of action of rt-PA?

A
  • Converts plasminogen into plasmin which lyses fibrin clots
19
Q

What is alteplase indicated for?

A
  • Ischemic stroke
20
Q

what are the side effects for alteplase?

21
Q

Thrombolytic drugs can be used to treat ischemic stroke. true or false?

22
Q

what is the issue with thrombolytic drugs and older clots?

A
  • older clots are more difficult to treat as they have more fibrin cross-linkages which reduces the efficacies of these drugs
23
Q

What are the causes of hemorrhagic transformation?

A
  • Damaged blood vessels
  • Injured blood vessels become leaky
  • Restored blood flow leads to hermorrhage
24
Q

What are the symptoms of hermorrhagic transformation?

A
  • increased BP
  • Neurological damage is worsened
  • Respiratory changes
25
What are the managements for HT?
- control BP - Possible surgery - CT - Avoid use of anticoagulants
26
what is the point of neuroprotection?
- NT aims to block the molecular cascade of injury following ischaemic stroke to minimise size of injury and to extend therapeutic window
27
What are the preventive steps to take to prevent stroke?
- Healthy lifestyle - Public awarness - Education - The earlier it is detected the better the outcome
28
What are the modifiable and non-modfiable risk factors of stroke?
``` Modifiable risks - Hypertension - Diabetes -High cholesterol Non-modifiable risks - Age - Gender - Heredity ```