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ACH - C.U > TIA and Stroke > Flashcards

TIA and Stroke Flashcards

1
Q

Crescendo TIA =

A

2< episodes within one week

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2
Q

4 causes of TIA

A

Embolus from carotid artery
Thrombus rom the heart due to AF
Infective endocarditis
Vasculitis

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3
Q

How long can’t you drive for with a TIA

A

4 weeks

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4
Q

If the patient has had more than 1 TIA (‘crescendo TIA’) or has a suspected cardioembolic source or severe carotid stenosis:

Management..?

A

300mg Aspirin immediately

discuss the need for admission or observation urgently with a stroke specialist

cannot drive until they see a specialist

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5
Q

If the patient has had a suspected TIA in the last 7 days:

Management..?

A

300mg Aspirin immediately

arrange urgent assessment (within 24 hours) by a specialist stroke physician

cannot drive until they see a specialist

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6
Q

Carotid stenosis 50-99% treatment

A

referred within 1 weeks for carotid endarterectomy

undergo treatments within 2 weeks

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7
Q

Carotid stenosis <50% treatment

A

no surgery just medical management

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8
Q

6 vascular risk factors for TIA

A 
HTN
IHD 
PVD 
Carotid stenosis 
Diabetes 
Smoking
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9
Q

4 thrombotic risk factors for TIA

A

AF
COC
Polycthaemia
Clotting disorders

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10
Q

TACS classification (3)

A

All 3 of ….

  • unilateral weakness
  • homonymous hemianopia
  • higher cerebral dysfunction
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11
Q

PACS classification (3)

A

2 of…

  • unilateral weakness
  • homonymous hemianopia
  • higher cerebral dysfunction
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12
Q

PCS classification (3)

A

1 of….

  • cerebellar / brainstem syndromes
  • loss of consciousness
  • isolated homonymous hemianopia
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13
Q

LACS classification (3)

A

1 of….

  • unilateral weakness (purely)
  • pure sensory stroke
  • ataxia hemiparesis
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14
Q

Definition of stroke

A

syndrome of rapid onset of cerebral deficit, usually focal lasting more than 24hrs

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15
Q

5 causes of ischaemic stroke

A 
Thrombosis 
Large artery stenosis 
Small vessel disease 
Cardioembolic 
Hypoperfusion
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16
Q

2 causes of haemorrhagic stroke

A

Intracerebral

subarachnoid

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17
Q

3 “other” causes of stroke

A

arterial dissection
venous sinus thrombosis
vasculitis

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18
Q

Clinical deficit associated with left middle cerebral artery

A

Right sided weakness of face & arm > leg and dysphasia

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19
Q

Clinical deficit associated with RMCA

A

left sided weakness - face & arm > leg, visual / sensory neglect, denial of disability

20
Q

Lesion to corticospinal tracts in BS leads to ….

A

hemiparesis / tetraparesis

21
Q

Lesion to oculomotor tract in BS leads to ….

A

dipolpia

22
Q

Lesion to 5th nerve nuclei -

A

facial numbness

23
Q

Lesion to 7th nerve nuclei -

A

facial weakness

24
Q

Lesion to 9th and 10th nerve nuclei -

A

dysphagia and dysarthria

25
Q

Lesion to sympathetic fibres in the BS -

A

Horners syndrome

26
Q

Lesion to reticular formation -

A

coma / altered consciousness

27
Q

If haemorrhagic stroke excluded what should be given straight away?

A

300mg aspirin

28
Q

At what cholestrol level should a statin be started post stroke?

A

3.5mmol/L

29
Q

Thrombolysis should be given within …..

A

4.5 hours after the onset of stroke symptoms

30
Q

What thrombolysis is currently recommended?

A

altepase

31
Q

4 causes of haemorrhagic stroke

A

HTN
Cerebral amyloid angiopathy
Aneurysms
Cerebral ateriovenousmalformations

32
Q

What stroke scale is used in assessment?

A

NIHSS (national institute of health stroke scale)

33
Q

Broca’s aphasia =

A

expressive aphasia

34
Q

Wernicke’s aphasia

A

receptive aphasia

35
Q

4 coagulopathies that can cause a stroke

A

Thromboycythaemia
Polycythaemia
Hyperviscosity states
Thrombophilia

36
Q

Which infections should be considered in stroke?

A

Neurosyphilis
HIV
Hepitits

37
Q

Structures that run through the cavernous sinuses (5)

A

3rd, 4th, 5th and 6th CN

Carotid artery

38
Q

Classical presentation of cavernous sinus thrombosis (3)

A

Proptosis
Chemosis
Painful opthalmoplegia

39
Q

Vasculitis can cause strokes secondary to either (2)

A

Infection

CTD

40
Q

Cerebral venous thrombosis associated with… (5)

A 
pregnancy 
puerperium 
oral contraception 
haematological disease 
infection 
CTD
41
Q

Defining features of cerebral venous thrombosis (4)

A

headache
altered conscious ness
seizures
papilloedema

42
Q

What should be considered if stroke symptoms after trivial neck trauma?

A

Dissection

43
Q

If the patient has had a suspected TIA which occurred more than a week previously:

A

refer for specialist assessment as soon as possible within 7 days

cannot drive until they see a specialist

44
Q

anti-platelet therapy started for those who have had a TIA?

A

Clopidogrel

45
Q

Contraindications to thrombolysis:

A
  • Previous intracranial haemorrhage
  • Seizure at onset of stroke
  • Intracranial neoplasm
  • Suspected subarachnoid haemorrhage
  • Stroke or traumatic brain injury in preceding 3 months
  • Lumbar puncture in preceding 7 days
  • Gastrointestinal haemorrhage in preceding 3 weeks
  • Active bleeding
  • Pregnancy
  • Oesophageal varices
  • Uncontrolled hypertension >200/120mmHg

ACH - C.U (4 decks)

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