Stroke & TIA Flashcards
How assess facial droop?
get them to smile
how to assess arm strength?
bilateral shoulder flexion
TIA definition?
neurological episodes <24 hours without damage on imaging
rule in stroke in ED if the patients knows?
exact time of onset
recall what they were doing
feeling well in the last week
small vessel stroke called? where affect?
lacunar infarct
affects subcortical
hemorrhagic stroke is better of worse than ischaemic?
worse 30-40% mortality
worse functional outcome
when do you normally get a deep hemorrhagic stroke?
hypertension, rupture of deep penetrating arteries
what kind of hemorrhagic stroke do you get with aneurysm, AV-malformation, tumour?
lobar
what cancer do you get bleeding metastasis?
melanoma
TIA usually lasts how long?
<10 minutes
what is a source of paradoxical embolism?
patent foramen ovale
DVT into brain
tPA administration timeframe?
<5 hours
why do you get fluctuating symptoms of stroke in some people?
collaterals
tPA contraindications?
bleeding risk (ie. warfarin) seizure at onset
when you’re in country looking at a CT scan, what is a tip to see if there is a thrombus?
partial volume effect
look at 1mm slice instead of 5mm slice to see through artery
3 investigations after you think it’s a TIA?
12 lead ECG
CT head
Carotid Dopplar
how to treat post TIA?
anticoagulant, statin, aspirin
difference between symptoms of migraine vs. TIA?
migraine spreads upwards from distal limb sometimes
TIA just happens
primary prevention of stroke?
smoking, HTN, DM2, obesity, exercise
Warfarin vs. Aspirin for AF?
NOT THE SAME
NOACs excretion how?
Renal: assesss renal function
CHADS2 score for?
risk of stroke vs. bleed
what is the paradigm shift in lowering BP and cholesterol?
ANY lowering of lowering BP and cholesterol good for secondary stroke prevention
Aspirin vs. clopidogrel?
clopidogrel more effective in prev of serious high risk vascular events
