9: Stroke Flashcards

1
Q

What is a stroke?

A

Rapidly developing loss of brain function due to a vascular event

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2
Q

Loss of brain function due to a stroke can be ___ or ___.

A

focal

global

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3
Q

What score is used to diagnose a stroke in A&E?

A

ROSIER score

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4
Q

What are the two main types of stroke?

A

Infarction

Haemorrhage

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5
Q

What does a CT head of an

a) infarction stroke
b) haemorrhagic stroke

look like?

A

a) Affected area is darker, smudged

b) Blood is lucent i.e bright white

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6
Q

What is a TIA?

A

Transient ischaemic attack

i.e mini stroke

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7
Q

What is the difference between a TIA and a stroke?

A

Time frame

TIA < 24hrs ongoing symptoms, stroke > 24hrs

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8
Q

What does TIA increase your risk of?

A

Stroke

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9
Q

___ intervention is key to reducing the risk of stroke following a TIA.

A

Early

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10
Q

How is suspected stroke investigated?

A

Imaging (CT or MRI scan)

Cardio investigations - blood pressure, ECG, carotid scans, angiograms…

Lifestyle - blood glucose, cholesterol, take a smoking history

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11
Q

What must be assessed before offering a stroke patient food or water?

A

Swallowing

To ensure patient doesn’t aspirate

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12
Q

What is an emergency intervention which can be given to a patient acutely suffering a stroke?

A

Thrombolysis

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13
Q

Which classes of drug are given to patients to reduce the likelihood of another stroke?

A

Statins

Antiplatelets e.g aspirin, clopidogrel, ticagrelor

Anticoagulants e.g warfarin, apixaban, LMWH

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14
Q

Which imaging modes are better for picking up

a) haemorrhages
b) infarcts?

A

a) CT

b) MRI

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15
Q

Which antiplatelet drug is given for infarcts?

A

Aspirin

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16
Q

What cardio disease does immobility increase your risk of?

A

DVT

> MI, stroke…

17
Q

Why isn’t LMWH given for DVT prophylaxis in stroke patients?

A

Increases bleeding risk

18
Q

What is used as DVT prophylaxis in stroke patients?

A

Pneumatic compression stockings

Intermittently expand and contract to push blood along

19
Q

Why can patients aspirate following a stroke?

A

Impaired swallow

20
Q

How can patients be assisted with feeding if they have an impaired swallow following a stroke?

A

NG feeding

Thicker, textured food

Parenteral nutrition

21
Q

How are stroke patients assessed for malnutrition?

A

MUST score

22
Q

What is a red thrombus?

Where are they formed?

Which drugs are effective for breaking them up?

A

Clot formed mainly of red blood cells and fibrin

Found in areas of low pressure and blood status e.g heart

AntiCOAGULANTS - warfarin, apixaban

23
Q

What is a white thrombus?

Where are they formed?

Which drugs are effective for breaking them up?

A

Clot formed mainly of platelets

High pressure circulation e.g the arteries

AntiPLATELETS - aspirin, clopidogrel, ticagrelor

24
Q

Patients who have had MIs, strokes etc. often have hypertension in the days following their event.

What drugs are given to control this and when?

A

Antihypertensives i.e ACE inhibitor, amlodipine at around 10 days post-event

25
Q

What

a) lifestyle advice
b) medication

is given to stroke patients for secondary prevention?

A

a) Stop smoking, exercise, diet…

b) Statin, antiplatelet, anticoagulant

26
Q

Which arrythmia increases your risk of MI and stroke?

A

Atrial fibrillation

27
Q

What scoring system is used to estimate a patient’s risk of stroke?

A

CHA2D vasc score

revise from 1st year

28
Q

What scoring system is used to estimate a patient’s risk of bleeding while on anticoagulation?

A

HASBLED

29
Q

What type of diet is thought to be cardioprotective?

A

Mediterranean diet

high in starchy food, fruit and veg; low in meat