Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 2: Clinical medicine > Week 3 > Flashcards

Week 3 Flashcards

1
Q

where does stroke fall in the ranking of death/disability in the US

A

5th leading cause of death (used to be 3rd)

leading cause of long term diability and long term hospitalization

795000 Americans have a stroke each year (1/4 are recurrent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what ethnicities are more prone to strokes

A

black americans and hispanic population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

common risk factors for stroke

A

atherosclerosis

lifestyle factors

HBP

smoking

obesity

“brain attack”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what region of the US has the highest prevalence of stroke

A

southeastern states

“stroke belt”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hypothesis for why the southeastern region has a high % of stokes

A

poor nutrition; high in fat

greater smoking rates/hx tobacco farms

untreated HTN; greater barriers to health care access

socioeconomic and race factors; high poverty and minority population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prevalence of stroke based on age and gender

A

steady incline between 45 and 85

males are more common until 75 (females live longer)

rare below 45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

non-modifiable risk factors for stroke

A

Age
Gender
Family hx
Race
hx of stroke
certain blood disorders (i.e. sickle cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

modifiable risk factors for strokes

A

HTN
smokin g
diabetes
high cholesterol
inactivity/obesity
arteriosclerosis
history of TIA
atrial fib
excessive alcohol intake
illegal drug use
oral contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

job as PT in terms of stroke prevention

A

stress to patients the modifiable changes that can make

especially following a prior stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the symptoms and warning signs of a stroke

A

Sudden weakness/numbness of face/arm/body, especially one sided

sudden confusion/trouble speaking/understanding

sudden trouble walking/dizziness/loss of balance/coordination

sudden severe headaches w/o cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

acronym for stroke signs

A

FAST

Face drooping
Arm weakness
Speech difficulty
Time to call 911

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the technical definition of a stroke

A

sudden loss of neuro function caused by INTERRUPTION OF BLOOD FLOW TO BRAIN

aka CVA

can result from bloackage or rupture of the vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of stroke is most common

A

ischemic > hemorrhagic

87% of strokes

hemorrhagic produce greater consequences though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the types of strokes/subtypes

A

ischemic
hemorrhagic
-intracerebral ~10%
-subarachnoid ~5%
transient ischemic attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an infarct

A

small localized area of dead tissue resulting from loss of blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does an ischemic stroke occur

A

obstructed vessels result in poor blood flow to brain

20-25% of regular blood flow is required for the cells to survive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is TPA

A

clot buster

can be given in 3-4 hours of stroke onset and can remove clot

decreases length of ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

embolism vs thrombosis

A

thrombosis = static clot; results in artherosclerosis plaques that form in the brain over time and block blood flow

embolism = floating clot that travels to brain and blocks blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

common sources of emboli

A

heart is most common; usually due to afib or other valvular disease

ICA; clot originates at bifurcation of common carotid

20
Q

what are the subtypes of thrombotic strokes

A

large vessel; i.e. MCA/carotid

small vessel (lacunar); due to blockage of lenticulostriate arteries, medullary arteries, or other small vessels that branch off of main vessels; these “mini strokes” can lead to dementia

21
Q

what can caise conditional cerebral ischemia

A

low systemic perfusion pressure (LBP)

anoxia (arteries dont get perfused due to poor pressure and absence of O2)

diaschisis = system shock; stroke like temporary loss of function within a region not directly affected by the original stroke or neurologic injury that occurs due to system shock not edema or direct damage to structures

22
Q

describe a hemorragic stroke

A

reuptured blood vessel results in bleeding in brain

10-15% of strokes

caused by weak vessels

blood accumulates and compresses brain tissue

23
Q

what is an intracerebral hemorrhage

A

hemorrhage within the brain

24
Q

what is a subarachnoid hemorrhage

A

between inner and outer layers of tissue covering brain

occurs when blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and skull

25
what are the 2 types of weakened blood vessels that cause a hemorrhagic stroke
aneurysms (25% of people with cerebral aneurysm rupture don't survive 24 hours) arteriovenous malformation (AVMs) TPA not appropriate for this type of stroke; no clot to bust
26
common reasons for a hemorrhagic stroke
uncontrolled HTN AVM (congenital) aneurysm cavernous malformation vasculitis amyloid angiopathy venous thrombosis/infart tumor
27
symptoms of a hemorrhagic stroke
sudden intense HA (b/c blood has no where to go) neck pain N&V (b/c pressure on brainstem) Raised intracranial pressure (ICP)
28
what is a TIA
temporary blockage of blood flow to brain warning stroke/temporary symptoms last 24 hours or less medical emergency with same symptoms as ischemic and hemorrhagic stroke "warning sign"
29
how does TIA act as a warning sign for strokes
often procede full strokes or other CV problems later 1/5 people who have TIA will have a stroke within 90 days often not taken seriously, but with medical help pts can get early intervention and reduce risk of actual stroke
30
what is a silent stroke
undetected; blood vessels die but no warning signs or symptoms are present small vessel ("lacunar") strokes NOT TIA, just poor outward presentation can be seen in advanced brain imaging techniques such as MRI and CT
31
how are silent strokes linked to vascular dementia
linked to subtle problems in mobement/mental processing common with older individuals and people who smoke or have hx of vascular disease 1/4 people over 80 had at least one area of tissue death in brain w/o knowledge of occurence due to lack of residual deficits
32
what is the primary ischemic zone
area primarily affected by blood being cut off death of several neural cells not being perfused with blood cells die and dont regenerate severe = blood flow below 10-25%
33
what is ischemic penumbra
secondary area affected by ischemic stroke region surrounding primary zone; mild to moderate ischemia not directly affected by embolism/thrombosis and direct loss of blood supply subject to ischemic cascade and cerebral edema area where early spontaneous recovery occurs in neural repair
34
what is an ischemic cascade
release of excess neurotransmitters causes disturbance of energy metabolism and anoxic depolarization inability of brain cells to produce ATP
35
what is diaschisis
temporary transient loss of function in areas of the brain not directly affected by injury due to reduction of blood flow or system shock
36
what is cerebral edema
accumulation of fluids in brain due to tissue necrosis and widespread rupture of cell membranes begins w/i minutes of ischemia but peaks at 3-4 days TIME MATTERS: neuroplasticity principle can have spontaneous recovery where swelling subsides/resolves in 2-3 weeks can elevate intracranial pressure
37
how can elevated ICP present
cheyne-stokes respiration irregular HB impaired arousal/consciousness
38
significance of circle of willis
redundancy in circulation blood rerouted to continue perfusion of brain even with blockages delays ischemic cell death still need 20-25% perfusion
39
what is tissue plasminogen activator
"clot buster" gold standard for treatment of ischemic stroke administered with 3 hours of symptom onset protein that catalyzes conversion to plasmin breaking down clot ischemic stroke only pts with tPA 33% more likely to have minimal or no disability at 3 months post stroke
40
types of anticoagulation therapy
heparin (lovenox) warfarin (coumadin) - for pts with afib short term treatment
41
tyoes of antiplatelet therapy
asprin platelets form clots, thus these prevent clots recommended for prevention of secondary strokes long term treatment
42
how is blood pressure managed for ischemic strokes
permissive hypertension BO is allowed to remain hypertensive to keep brain perfused
43
how is blood pressure controlled for hemorrhagic stroke
usually caused by uncontrolled hypertension BP is normalized to prevent futher hemorrhage cease antiplatelet adn anticoagulant therapies to stop bleed and regulate pressure hemodynamically unstable
44
what risk factors should be agressively treated for medical management of strokes
cessation of smoking; reduce ischemic risk by half anticoagulant meds to reduce afib risk manage HTN stay active; reduced risk by 18% if exercise 5x/wk
45
PT role for stroke pt
return to function/life increase participation in society prevent secondary complications/future strokes establish POC
46

Year 2: Clinical medicine (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions