Thrombotic diseases (Stroke, PAD, DVT) Flashcards
What is stroke
Happens when blood supply to the brain is cut off so brain cells die
List the risk factors of stroke
- Inactivity
- smoking
- obesity
- HBP
- diabetes.
List symptoms of stroke
- FAST
Face : has their face fallen on one side
Arms: can they raise both arms and keep them there
Speech: is their speech slurred
Time to call 999: if you see any single one of these signs.
Describe the THREE types of stroke
- Ischaemic stroke (75% - 85%):
There’s a blockage that prevents supply of blood to the brain. E.g.- Thrombosis: blood clot in blood vessels
- Embolism: (blood clot in artery)
- Haemorrhagic stroke (15%-25%):
Caused by bleeding in or around the brain. Divided into.- Intracerebral: due to hypertension, trauma, bleeding disorders
- Subarachnoid (surface of the brain): due to aneurysm
- Transient ischaemic attack (TIA): Temporary blockage of blood supply. It is the same as a stroke, except that the symptoms only last for a short amount of time. This is because the blockage that stops the blood getting to your brain is temporary.
How can you ASSESS the risk of stroke after a TIA.
and state the limitation of using this prognosis
ABCD2 score
A Age ≥ 60 = 1 point
B Blood pressure ≥ 140/90mmHg = 1 point
C. Clinical features: unilateral weakness = 2points;
speech disturbance without weakness = 1point
D- Duration of symptoms: 10 - 59minutes = 1point;
60 minutes or longer = 2points
presence of diabetes: 1point
ABCD2 score ≥ 4 = high risk of stroke
Start 300mg Aspirin immediately
Limitations: cannot be used in patients with recurrent TIA or on
anticoagulant treatment
Describe pharmacological treatment for Ischemic stroke
- 300mg aspirin immediately for 2 weeks
- Tissue Plasminogen Activator (tPA)
promotes breakdown of fibrin - Carotid angioplasty
Describe pharmacological treatment for Haemorrhagic stroke
- Removal or clipping of aneurysm
- Anti-hypertensives
- Reversing anticoagulants (if any)
List non -pharmacological advice/ Rehabilitation of stroke
- Physiotherapy (e.g. learning to walk)
- Speech and language therapy (e.g. learning to talk)
- Occupational therapy (e.g. shopping)
- Psychiatrist
What is Peripheral artery disease (PAD)
it is atherosclerosis in the lower extremities (leg).
Blocking movement of blood from the heart to the legs
what are causes and symptoms of PAD
Causes
- smoking
- obesity
- HBP
- Diabetes
Symptoms
- poor skin
- pain while walking
How is PAD diagnosed
- Ankle-brachial index (ABI) Test
So, blood pressure in ankle and arm should be measured
Normal systolic blood pressure in ankle / arm = 0.9 - 1
<0.9 = PAD 0.71 - 0.9 = mild PAD 0.41 - 0.7 = moderate PAD <0.4 = severe PAD
How is PAD treated
- anti-platelet drugs
- Medications for hyperlipidaemia, diabetes & hypertension
-Change of lifestyle: regular exercise, smoking cessation, weight reduction for obese & reduce alcohol consumption
What is DVT
Blood clot in the deep veins of your body usually in the legs
Explain causes of DVT
- Inactivity – immobility e.g. during/after surgeries, long journeys
- long stays at hospitals with reduced activity
- Medical conditions such as cancer treatments – chemo & radiotherapy can increase the clotting activity
- Pregnancy – makes blood to clot quickly
Combined contraceptive pills can cause blood to clot easily - Previous DVT
- obesity
- smoking,
How is DVT diagnosed
Ultrasound scan,
blood test for d- dimer levels,
venogram
