Stroke Flashcards
What is the most common risk factor for stroke? A.) Age>55 B.) HTN C.) Smoking D.) DM II
B
Hypertension (most important)
A.fib (most common cause of cardioemolic stroke)
Door-to-needle time for ischemic stroke? A.) 90 mins B.) 120 mins C.) 60 mins D.) 45 mins
C
Within 60 mins of hospital arrival
For ACS: within 30 mins
Door to balloon: within 90 mins
PCI upon medical contact: within 120 mins
Preferred tx for patients with non-cardioembolic stroke or TIA?
Antiplatelets over oral anticoagulants
MOA of aspirin?
A.) initiates local fibrinolysis by binding to fibrin in a thrombus (clot) and converts entrapped plasminogen to plasmin
B.) irreversibility binds to COX1 and COX2 resulting in decreased PG and TXA2 production
C.) inhibits the uptake of adenosine into platelets and increase cAMP levels, which inh platelet aggregation
D.) irreversibly inh P2Y12 ADP-mediated platelet activation and aggregation
B
Clopidogrel is a prodrug which is metabolized by which CYP450 enzyme? A) CYP2D6 B.) CYP2C9 C.) CYP3A4 D.) CYP2C19
D
Clopidogrel should be avoided with which 2 PPIs due to the risk of decreasing effectiveness of clopidogrel? (select all that apply). A.) Omeprazole (Prilosec) B.) Lansoprazole (Prevacid) C.) Pantoprazole (Protonix) D.) Esomeprazole (Nexium)
A, D
Which of the following agents used in secondary stroke prevention has a risk of causing thrombotic thrombocytopenic purpura (TTP)? A.) Clopidogrel B.) Aspirin C.) Dispyridamole D.) Nimodipine
A
TTP has been historically linked to a pentad of clinical features (mental status changes, fever, acute renal failure, anemia and thrombocytopenia).
TTP is a blood disorder in which clots form throughout the body. The clotting process consumes platelets and leads to bleeding under the skin and formation of purpura (bruises) and petechiae (dots) on the skin.
What medication is used to prevent cerebral artery vasospasm due to SAH? A.) amlodipine B.) nifedipine C.) nicardipine D.) nimodipine
D
CAPSULE, ORAL solution ONLY
MAKE SURE IT IS NOT GIVEN BY ANY OTHER ROUTE
More selective for cerebral arteries due to increased lipophilicity
MOA of dipyridamole?
A.) initiates local fibrinolysis by binding to fibrin in a thrombus (clot) and converts entrapped plasminogen to plasmin
B.) irreversibility binds to COX1 and COX2 resulting in decreased PG and TXA2 production
C.) inhibits the uptake of adenosine into platelets and increase cAMP levels, which inh platelet aggregation
D.) irreversibly inh P2Y12 ADP-mediated platelet activation and aggregation
C
MOA of Clopidogrel?
A.) initiates local fibrinolysis by binding to fibrin in a thrombus (clot) and converts entrapped plasminogen to plasmin
B.) irreversibility binds to COX1 and COX2 resulting in decreased PG and TXA2 production
C.) inhibits the uptake of adenosine into platelets and increase cAMP levels, which inh platelet aggregation
D.) irreversibly inhibits P2Y12 ADP-mediated platelet activation and aggregation
D
Aggrenox
aspirin + ER dipyridamole
Yosprala
aspirin + omeprazole
