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CVNOTES > Stroke > Flashcards

Stroke Flashcards

1
Q

Define Stroke:
Minor:
Disabling:

A

Define Stroke: Loss of function in the brain due to either Ischaemia (thrombus) or Haemorrhage (rupture).
Minor: > 24 hrs, minor neurological impairment
Disabling: > 24 hrs, persisting disability - impairs independence

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2
Q 
Stroke: Modifiable Risk Factors: 
HBP
S
A
D
PVD
HL
OC
A 
Stroke: Modifiable Risk Factors: 
High BP
Smoking
Alcohol
Diabetes
Peripheral Vascular Disease
Hyperlipidaemia 
Oral Contraceptive
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3
Q 
Stroke: Non-Modifiable Risk Factors: 
A
M
PH of
FH of
A 
Stroke: Non-Modifiable Risk Factors: 
Age
Male
Past History of Stroke
Family History of Stroke
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4
Q 
Transient Ischaemic Attack Symptoms:
LoS
LoS
LoV
LoC
LoC
LoP
H
V
NS
Ph
D
FND:
A 
Symptoms:
Loss of Speech
Loss of Sensation
Loss of Vision
Loss of Coordination
Loss of Consciousness
Loss of Power
Headaches
Vomiting
Neck Stiffness
Photophobia
Dysphagia - 50% find it difficult to swallow.
Focal Neurological Deficit: Sudden weakness/numbness in the face, arm, leg, and is often on one side of the body.
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5
Q

Symptoms: Anterior Communicating Artery:

A

Contra-lateral paralysis of foot and leg, sensory loss over the foot and leg, impaired gait of stance.

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6
Q

Symptoms: Middle Communicating Artery:

A

Contra-lateral paralysis of foot, arm, leg, sensory loss over the foot, arm, leg, Homonymous Hemianopia.

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7
Q

Symptoms: Left Hemisphere:

A

Right Hemiplegia (paralysis of one side of the body), Homonymous Hemianopia, Dysphasia (speech)

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8
Q

Symptoms: Right Hemisphere:

A

Left Hemiplegia (paralysis of one side of the body), Homonymous Hemianopia, Neglect Syndromes (Agnosias - visual agnosia, sensory agnosia, Anosagnoisa, Prosopagnosia)

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9
Q

Total Anterior Circulation Stroke: TAC = All three
1.
2.
3.

A

Total Anterior Circulation Stroke: TAC = All three

  1. Unilateral weakness/Hemiplegia (FAL)
  2. Homonymous Hemianopia
  3. Higher Cerebral Dysfunction - Dysphagia, Visuospatial Disorder
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10
Q

Partial Anterior Circulation Stroke: PAC = Two
1.
2.
3.

A

Partial Anterior Circulation Stroke: PAC = Two

  1. Unilateral weakness/Hemiplegia (FAL)
  2. Homonymous Hemianopia
  3. Higher Cerebral Dysfunction - Dysphagia, Visuospatial Disorder
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11
Q 
Lacunar Syndrome: LACs = One
1.
2. 
3. 
4. &
4b
A 
Lacunar Syndrome: LACs = One
1. Pure Sensory 
2. Pure Motor 
3. Sensory-Motor 
4. Ataxic Hemiparesis - &
4b = Dysarthria/clumsy hand
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12
Q

Posterior Circulation Syndrome POCs = One

  1. CNP
  2. BL M/S
  3. CEM/GP
  4. CBD - A, V
  5. IsHH/CB
A

Posterior Circulation Syndrome POCs = One

  1. Cranial Nerve Palsy & contralateral motor/sensory deficit
  2. Bilateral Motor/Sensory deficit
  3. Conjugate Eye Movement/Gaze Palsy
  4. Cerebella Disorder - Ataxia, Vertigo, Nystagmus
  5. Isolated Homonymous Hemianopia/Cortical Blindness
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13
Q 
Categories of Stroke
1.
2. 
3.
4.
A

Categories of Stroke

  1. TAC - Total Anterior Circulation
  2. PAC - Partial Anterior Circulation
  3. LAC - Lacunar Syndrome
  4. POC - Posterior Circulation Syndrome
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14
Q 
Stroke Investigations: 
B
E
E
C
C
C
M
A 
Stroke Investigations: 
Bloods - FBC,  Glu, Lipids, ESR (erythrocyte sedimentation rate)
ECG - AF, LVH
Echocardiogram - clots in heart 
CT - *haemorrhage*** 
Carotid Doppler US - stenosis
Cerebral Angiogram - vasculitis
MRI - *infarction*
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15
Q

Stroke Treatment:
Within 4.5 hours:
After 4.5 hours:

A

Stroke Treatment: MDT
Within 4.5 hours: Thrombolysis - to perfuse before cell death = Alteplase/Urgent CT Scan
After 4.5 hours: Contact Stroke Team.

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16
Q

Stroke Treatment:

Within 6 hours:

A

Stroke Treatment:

Within 6 hours: IV Thrombolysis & Thrombembocotmy

17
Q

What is the dose and route of administration of Thrombolytics in Stroke:

A

Alteplase (rt-PA) = Recombinant Tissue Plasminogen Activator:
Intravenous rt-PA 0.9 mg/kg
Up to 90mg max dose.

18
Q

Which Thrombolytic should not be used in Acute Stroke Phase:

What can be given:

A

Cannot: Streptokinase Thrombolytic
Can: Aspirin

19
Q

Other Stroke Treatments:
H
H
CE

A

Other Stroke Treatments:
Heparin
Hemicraniectomy - under 60yrs, within 48 hrs
Carotid Endarterectomy

20
Q 
Secondary Prevention of Stroke: 
AP
ACG
AHT
S
CE
W
A 
Secondary Prevention of Stroke: 
Anti-Platelets - Clopidogrel 75 mg,  Aspirin 75 mg + Dipyridamole ModR 200 mg
Anti-Coagulants - LMWH
Anti-Hypertensives - ACEI/ARB, CBBs
Statin
Carotid Endarterectomy
Warfarin - for AF.

CVNOTES (57 decks)

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