Thompson 1

Question 1

types of strokes

Answer 1

• Ischemic (80%)
  
  • thrombosis (clot in brain)
  • embolic (clot thrown to brain)
  • hypoperfusion
• Hemorrhagic (20%)
  
  • lots of types

Question 2

What is a TIA**

Answer 2

• STROKE-LIKE SYMPTOMS THAT RESOLVE IN 24 HOURS… MOST IN 3
  
  • OLD DEFINITION
• TRANSIENT episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, WITHOUT ACUTE INFARCTION
  
  • NEW DEFINITION

Question 3

In patients with TIA’s how do you determine if they stay or go home?**

Answer 3

• Based on AGE, BP, TIA symtpoms, DURATION and DIABETES (ABCD2)
  
  • more points, higher chance of leading to stroke
• if they are in transient state then they send home (if they are symptomatic they stay)

Question 4

DIFFERENTIAL (what can it be other than stroke)**

Answer 4

• Seizure
• hypoglycemia
• metabolic d/o (LOW K, LOW Na)
• encephalopathy
• brain lesion
• sepsis
• medication
• spinal cord issues

Question 5

Risk factors of stroke

Answer 5

• Thrombolic
  
  • HTN, CAD, DM, vascular dz, sickle cell, smoking, age
• Embolic
  
  • A-fib, PFO, valve replacement, MI, Age

Question 6

s/s of stroke

Answer 6

• weakness on one side
• numbness on one side
• issues with speech, thought, motion
• balance problems
• Headache
• seizure
• visual changes
• LOC
• not syncope

Question 7

Define stroke window ***

Answer 7

• There is a 3 hr windown from the start of symptoms to start thrombolytics
  
  • this window can be EXTENDED to 4.5 hrs to those under 80, not on a thinner, NIH stroke scale <25, non diabetic and no previous stroke

Question 8

Contraindications to giving TPA****

Answer 8

• Bleed, tumor, huge stroke on CT with mass effect, brain swelling
• more than 3 (to 4.5) hours from onset of symptoms (have to be precise - nap/going to be starts the clock)
• Resolving symptoms or minor symptoms