Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3MB Ageing > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a stroke?

A

Collection of rapidly developing symptoms that are indicative of focal (sometimes global) brain damage with a vascular origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is stroke a diagnosis?

A

No - it leads to a diagnosis i.e. the underlying cause of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 main things you must note in a stroke history?

A

Time of onset
Symptoms
Progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is it important to note time, symptoms and progression?

A

Various conditions can mimic a stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name some conditions that can mimic a stroke

A

Seizures (Todd’s paresis causes unilateral weakness)
Sepsis (in patients with cerebral scar tissue from previous stroke)
Metabolic/toxic disorders
Hypoglycaemia
Dementia
Delirium/confusion
Space occupying lesions e.g. brain tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the main screening tool for assessing the likelihood of a stroke?

A

ROSIER Score
<0 = less likely
>0 - 1 = more likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the types of stroke?

A

Haemorrhagic
Subarachnoid haemorrhage
Infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name causes of haemorrhagic stroke

A 
Structural abnormalities 
Extreme hypertension (causes vascular damage increasing risk of bleeding)
Amyloid angiopathy (deposition of amyloid protein makes vessels more friable and prone to bleed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name causes of subarachnoid haemorrhage stroke

A

Head injury

Ruptured aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name causes of infarct stroke

A 
Structural abnormalities 
AF causing cardioembolic stroke 
Atherosclerosis causing Atheroembolic stroke 
Thrombophilia 
Small vessel disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can you clinically differentiate between each stroke type?

A

No, only through imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first line imaging for stroke?

A

CT Scan

UNLESS:

  • Patient presents >1 week late
  • Stroke is minor (MRI more sensitive)
  • Stroke is posterior (increased bone presence causes interference on CT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does blood show on a CT?

A

Bright white, due to iron presence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What must be remembered regarding haemorrhage and CT?

A

Blood is reabsorbed within 3 weeks of haemorrhage leaving an empty space and scar tissue so may not always be obvious on CT

Conduct MRI if patient presents >1 week late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What must be remembered with infarcts and CT?

A

CT MAY BE CLEAR

For infarcts to show on a CT, necrosis and oedema must occur, which takes time. If CT is conducted prior to this stage, it will be clear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What imaging modality is good for infarct stroke?

A

MRI

Look for unilateral areas of corresponding black and white (ischaemic tissue impairs iron and water flow, resulting in these black and white areas)

17
Q

List symptoms of stroke

A

Facial weakness and droopiness
Arm weakness
Slurred speech

18
Q

What is the name given to salvageable brain tissue?

A

Penumbra

Stroke is a dynamic process, meaning brain is initially salvageable

19
Q

What exam must always be done in ALL stroke patients?

A

Neurological exam

20
Q

How is haemorrhagic stroke managed?

A

Control BP

  • If patient presents in <6 hours and BP >150mmHg, give IV GTN
  • If >6 hours, give Amlodipine

Reverse anticoagulants if patient is on any

21
Q

How is infarct stroke managed?

A 
Thrombolysis/Thrombectomy
Swallowing Assessment 
Hydration and Nutrition 
Antiplatelets 
Stroke unit care 
DVT prophylaxis
22
Q

What antiplatelets are given in stroke?

A

300mg Aspirin OR Aspirin with Clopidogrel (better in minor strokes or TIA)

23
Q

What is thrombolysis?

A

Giving IV TPA to break down clots

24
Q

What must be remembered about thrombolysis?

A

Cut off is 4.5 hours
May not work on large or proximal clots
Age does not matter
Bleeding is a side effect (check for previous stroke, hypertension and diabetes)

25
Q

What is endovascular therapy?

A

Putting a wire through the clot and opening a stent around it to pull it out.

Done for large or proximal clots

26
Q

What are consequences of stroke?

A

Aspiration pneumonia due to loss of coordination of swallowing muscles

DVT due to immobility (intermittent compressions stockings for prophylaxis)

27
Q

What is a TIA?

A

Mini stroke and first aspect of the stroke spectrum which acts as a warning sign for future, more serious strokes

28
Q

Are TIAs benign?

A

NO

Sign of an underlying vascular issue that needs to be managed

29
Q

What are investigations for a TIA?

A

History
Blood tests
Carotid imaging for stenosis in the carotid arch, vessels and cerebral vessels
ECG

30
Q

What screening tool is used to assess the likelihood of TIA and recurrent TIAs?

A

ABCD2

Checks age, BP, clinical features and diabetes

31
Q

How is a TIA managed?

A

Immediate therapy starting from the GP office

Statin to reduce risk
300mg Aspirin or Aspirin with Clopidogrel
Carotid Endarterectomy for carotid stenosis

3MB Ageing (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions