Stroke therapy

Question 1

What is the best management, and improves survival after a stoke

Answer 1

Stroke unit care

Question 2

What is the purpose of thromblysis treatment

Answer 2

Restore perfusion before cell death occurs

Question 3

Why is thrombolysis a time dependant treatment

Answer 3

As the benefit of treatment delays with time, as every minute the damage worsens, making it harder for blood flow to be restored

Question 4

What should be administrated on the sing of an acute stroke

Answer 4

Thrombolysis - but not in hemorrhagic

Question 5

Why should streptokinase not be administrated in the presentation of an acute stroke

Answer 5

streptokinase produced from bugs casuesi increased risk of anaplhyaltic reaction to it

Question 6

What is an example of a fibrinolytic agent in thrombolysis

Answer 6

ateplase

Question 7

How is fribriolytic agent administrated in an acute stroke

Answer 7

Intravenously

Question 8

What is the surgical from of thrombolysis performed in an acute stroke

Answer 8

Clot retrieval

Question 9

How does clot retrieval work in the treatment of an acute stroke

Answer 9

mechanical removal of a blood clot from a patient’s brain

Question 10

What is the disadvantage of thrombolysis in acute stroke treatment

Answer 10

Causes unexpected bleeding

Question 11

What increases the risk factor of haemorrhage after thrombolysis

Answer 11

Infarct size 
vessel occlusion
diabetes 
blood pressure 
age 
stroke severity 
tissue changes  
antiplatelets

Question 12

Is thrombolysis going to be effective if brain tissue is dead?

Answer 12

No as won’t be able to perfuse the blood

Question 13

What affect does age have on thrombolysis

Answer 13

the greater the age the greater the risk of bleeding

Question 14

When would thromolysis benefits outweigh the risks

Answer 14

If administrated up to 4.5hours from the onset of symptoms

Question 15

What protocol would be followed for patients with suspected stroke

Answer 15

— ambulance priority (blue light) in appropriate cases
— rapid triage on arrival at hospital
— immediate access to specialist stroke services — rapid brain imaging
— rapid specialist assessment

Question 16

Recognisable symptoms of a stroke

Answer 16

e.g. Facial weakness Limb weakness
Speech disturbance (dysphasia or dysarthria) Hemianopia

Question 17

What is a hemicraniectomy

Answer 17

— the removal of half the skull

Question 18

What is the purpose of a hemicraniectomy

Answer 18

— has been shown to help relieve pressure and prevent herniation as the brain expands

Question 19

Would should a hemicraniectomy be performed on

Answer 19

individuals aged up to 60 years who suffer an acute MCA territory ischaemic stroke complicated by massive cerebral oedema, surgical decompression

Question 20

What is the 4 different management of ischameic stroke

Answer 20

Stroke unit
thrombolysis
aspirin
hemicraniectomy

Question 21

When would secondary prevention management be given

Answer 21

Patents who have surrfered a stroke or present with TIA

Question 22

What is secondary prevention treatment

Answer 22

Clopidogreal
aspirin
BP drugs
Statin

Question 23

What is a Carotid endarterectomy

Answer 23

surgical procedure used correcting stenosis (narrowing) in the common carotid artery

Question 24

What is the purpose of aCarotid endarterectomy

Answer 24

Reduces the risk of stroke

Question 25

When would thrombolysis not be administered in the presentation of an acute stroke

Answer 25

If the stroke is due to a haemorrhage