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The Patient (Y3-2) > Stroke > Flashcards

Stroke Flashcards

1
Q

What are the causes of an ischaemic stroke?

A

Cerebral thrombosis from atherosclerotic disease

Distal embolism from cardioembolic disease

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2
Q

In haemorrhagic stroke, in which two places can the bleed take place in?

A

Intracerebral - rupture of small vessel

Subarachnoid - rupture of aneurism in subarachnoid space

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3
Q

What are the symptoms of stroke?

A 
FAST
Facial weakness
Arm or leg weakness
Speech 
Time - call 999 if any of symptoms present
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4
Q

Men at higher risk of stroke and more men die of it than women. True or false?

A

False - higher risk men but more women die

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5
Q

What are the modifiable risk factors of stroke?

A

Hypertension
Smoking
AF
Diabetes

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6
Q

What are the non-modifiable risk factors of stroke?

A

Age
Gender
Family history

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7
Q

What type of scan is done to investigate stroke?

A

CT scan - will identify whether or not there is a bleed. If no bleed then can initiate treatment for ischaemic stroke

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8
Q

After patient gets admitted to hospital and CT scan identifies ischaemic stroke, what would patient be given?

A

Alteplase

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9
Q

What type of drug is alteplase?

A

Thrombolytic

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10
Q

How soon after onset of symptoms should alteplase be given?

A

Within 3 hours of symptoms onset - licensed for up to 4.5hrs but more effective if given sooner

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11
Q

If patient with ischaemic stroke cannot be thrombolysed, what drug is given instead?

A

300mg aspirin

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12
Q

If aspirin is given instead of alteplase how long should it be continued for?

A

up to 14 days

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13
Q

If patient has been thrombolysed, are they given aspirin?

A

Yes, wait 24hrs before offering aspirin, CT scan repeated to ensure no bleed (haemorrhagic transformation) then aspirin started for 2 weeks

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14
Q

What is the acute treatment option for haemorrhagic stroke?

A

Neurosurgical intervention sometimes necessary if on-going bleed
Anti-coagulants stopped and reversed if INR >1.4

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15
Q

How can anticoagulants be reversed?

A

Vitamin K

Prothrombin complex concentrate

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16
Q

What lipid lowering treatment is given in ischaemic stroke?

A

High intensity (atorvastatin 20-80mg) as soon as patient can swallow safely

17
Q

What would you do if patient has high blood pressure and needs to be thrombolysed?

A

BP needs to be reduced before thrombolysis initiated if BP >185/110 mmHg

18
Q

Is BP always controlled with meds in acute stroke?

A

Fluctuations of BP common after acute stroke - only manage high BP if hypertensive crisis, complications of hypertension arise e.g. MI or patient has high BP and and needs thrombolysis

19
Q

What are the long-term treatments for ischaemic stroke. For example, patient has been on aspirin for 2 weeks, what are they given to prevent further stroke?

A

All patients start clopidogrel

20
Q

If clopidogrel not tolerated, what can patients be given long-term instead?

A

Aspirin plus MR dipyridamole

21
Q

If aspirin and clopidogrel not tolerated, what can patients be given long-term?

A

MR dipyridamole

22
Q

What type of drug is clopidogrel?

A

Antiplatelet

23
Q

Which drug cannot be given in AF?

A

Clopidogrel

24
Q

If patients experience GI side effects with clopidogrel, what drug can also be given?

A

PPI e.g. omeprazole

25
Q

In which cases are anticoagulants given in long-term treatment?

A

Ischaemic embolic stroke

26
Q

Name an anticoagulant that can be initiated as long-term treatment for an ischaemic embolic stroke

A

Apixaban
Rivaroxaban
Dabigatran
Warfarin

27
Q

Which antihypertensives can be given long-term?

A

If patient >55yrs, CCB e.g. diltiazem

If patient <55yrs, ACEI e.g. lisinopril

28
Q

Which patients are given statins as long-term treatment?

A

All ischaemic stroke patients - atorvastatin mainly

29
Q

Antihypertensives are only given to ischaemic stroke patients as part of long-term treatment. True or false?

A

False - also given to haemorrhagic stroke patients

The Patient (Y3-2) (8 decks)

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