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Patho/Pharm Exam 3 > Stroke > Flashcards

Stroke Flashcards

1
Q

Stroke

A

Ischemia to part of brain that results in death of brain cells

  • neuro metabolism altered in 30 sec
  • metabolism stops in 2 minutes
  • cell death in 5 minutes
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2
Q

Ischemic stroke

A

Ischemia to brain from partial or complete artery occlusion

  • most strokes
  • transient, thrombotic, embolic
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3
Q

Thrombotic stroke

A

Injury to blood vessel wall and formation of clot (most common cause)

  • narrowing of blood vessel
  • most associated with HTN and DM
  • preceded by TIA
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4
Q

Embolic Stroke

A

Embolus lodges in and occluded in a cerebral artery

  • infarction and edema
  • rapid occurrence of severe symptoms
  • usually remain conscious but might have headache
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5
Q

Transient ischemic attack

A

Temporary focal loss of neuro function by ischemia

  • most resolve in 3 hours
  • may be due to microemboli
  • warning sign of progressive cerebrovascular disease
  • Dx: CT without contrast
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6
Q

Hemorrhagic stroke

A

Bleeding into the brain tissue or subarachnoid space or ventricles

  • inter cerebral: HTN is most likely cause, occurs during periods of activity
  • sudden onset of symptoms with progression over minutes to hrs
  • neuro deficits, headache, NV, decreased LOC, HTN
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7
Q

Risk factors

A
  • age, gender, race, family
  • HTN
  • metabolic syndrome
  • heart disease
  • alcohol consumption, poor diet
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8
Q

Right CVA

A

Paralyzed left side
Spatial perceptual and visual field deficits
Tends to minimize problems
Short attention span
Impaired judgement: impulsive, impaired time concept

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9
Q

Left CVA

A 
Paralyzed right side hemiplegia
Impaired speech and language
Slow performance 
Visual field deficits
Aware of deficits: depression, anxiety
Impaired comprehension: math and language
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10
Q

Motor function

A

Impairment of respiratory function, swallowing/speech, gag reflex
-initial period of flaccidity followed by the spasticity

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11
Q

Broca’s Aphasia

A

Nonfluent Aphasia

  • damage to frontal lobe
  • speak in short phrase, omit small words
  • understand speech
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12
Q

Wernicke’s aphasia

A

Fluent aphasia

  • damage in left temporal lobe
  • speak in long sentences that have no meaning
  • often unaware of their mistakes
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13
Q

Agnosia

A

Inability to use an object correctly

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14
Q

Apraxia

A

Inability to carry out a purposeful activity

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15
Q

Ataxia

A

Inability to coordinate muscle activity during voluntary movement

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16
Q

Hemianospia

A

Blindness in half visual field

17
Q

Homonymous hemianopsia

A

Blindness in same half of the visual field of both eyes

18
Q

Neglect

A

Visual change that often occurs after a stroke in the right hemisphere of the brain

19
Q

Hemiplegia

A

Paralysis on one side of the body

20
Q

Hemiparesis

A

Weakness on one side of the body

21
Q

Primary Dx

A

CT scan within 25 minutes and read within 45 minutes of arrival at ER

  • indicates size and location of lesion
  • differentiate between ischemic and hemorrhage stroke
22
Q

Prevention of stroke

A
  • reduce salt and sodium intake
  • maintain of normal body weight
  • normal BP
  • increase exercise
  • avoid cigarettes and tobacco
  • limit alcohol to moderate levels
  • low in saturated fats, total fat, and cholesterol
23
Q

Primary prevention

A

Control BP

Treat hyperlipidemia

24
Q

Secondary Prevention

A

Antiplatelet drugs

  • aspirin
  • clopidogrel
25
Q

Surgery

A

Endarterectomy for TIAs (those at risk or after stroke)

Extracranial/intracranial bypass

26
Q

FAST

A

Face: look even?
Arm: one arm hanging down
Speech: slurred
Time: call 911

27
Q

Initial interventions

A
  • Airway
  • stroke code or stroke team
  • remove dentures
  • pulse oximetry
  • maintain BP
  • remove clothing and obtain CT
28
Q

Suspected stroke

A

Immediate general assessment <10 minutes of arrival
Immediate neuro assessment <25 minutes from arrival

Does CT show hemorrhage?

  1. No: acute ischemic: is fibrinolytic therapy right? Symptom length
  2. Yes: consult neurosurgery
29
Q

Clipping or coiling of an aneurysm

A

Admin of nimodipine before or after clipping

  • restricts influx of calcium
  • take BP and apical pulse before admin and hold if pulse <60 or SBP: <90

Patho/Pharm Exam 3 (13 decks)

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