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Neuro II Exam 2 > Atherosclerotic Cerebrovascular Disease with CVA and TIA - Pales > Flashcards

Atherosclerotic Cerebrovascular Disease with CVA and TIA - Pales Flashcards

1
Q

3rd leading cause of death in US

A

stroke

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2
Q

CVA

A

stroke

abrupt onset of neuro eficit - attributable to focal vascular cause

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3
Q

types of strokes

A

hemorrhagic

ischemic (majority)

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4
Q

ischemic penumbra

A

brain tissue around necrosis that is reversible - with appropriate tx

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5
Q

large artery thrombosis

A

rupture of plaque with fibrous plaque

blood clot forms - occluding artery

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6
Q

emboli

A

from atherosclerotic plaque or thrombus

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7
Q

paradoxical emboli

A

from lower leg DVT

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8
Q

atrial cardiac emboli

A

A-fib
atrial septal aneurism
tumor - myxoma

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9
Q

A-fib

A

fast/ineffective atrial contraction

-stasis and thrombus formation

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10
Q

atrial septal aneurysm

A

weak and outpouch of septum - stasis and thrombus formation

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11
Q

atrial myxoma

A

piece of tumor tear off and embolize

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12
Q

ventricular emboli

A

cardiomyopathy
MI
ventricular aneurysm

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13
Q

cadiomyopathy

A

weak dilated ventricle - stasis and thrombi formation

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14
Q

libman sacks endocarditis

A

with SLE

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15
Q

marantic

A

non-bacterial thrombi from cardiac source

malignancy or hypercoag state

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16
Q

tighter the stenosis

A

higher risk of stroke

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17
Q

hole in heart

A

with paradoxical emboli

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18
Q

lacunar infarct

A

subcortical areas of brain
-asymptomatic/minor sx

large artery branch to small artery right away - get lipohyalinosis from high pressure

hyperplasia and hyalinosis of vessel walls - narrow and occluded

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19
Q

watershed infarct

A

with profound hypotension

sepsis, bleeding, dehydration

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20
Q

hemostasis

A

3 parts working other

coag system
anticoag system
thrombolytic system

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21
Q

hypercoagulable state

A 
factor V - leiden mutation
protein C and protein S
antithrombin deficiency
plasminogen deficiency
prothrombin mutation
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22
Q

antiphospholipid Ab syndrome

A

arterial clotting

anticardiolipid Abs
lupus anticoagulantas

hyperhomocysteinemia

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23
Q

hyperhomocysteinemia

A

hypercoag

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24
Q

other hypercoag states

A 
pregnancy
cancer
HRT
prolonged bed rest/immobile
myeloproliferative
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25
Q

vasculitis

A

inflammed vessels

-cause of stroke

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26
Q

vasospasm

A

cocaine use

stroke

27
Q

moyamoya disease

A

large intracranial artery occlusion

28
Q

stroke presentation

A

depend on size of vessel

area of brain supplied by vessel

29
Q

weakness of one side of body

A

hemiparesis

30
Q

paralysis of one side of body

A

hemiplegia

31
Q

loss vision same visual field both eyes

A

homonymous hemianopia

32
Q

difficulty perform math

A

acalculia

33
Q

difficulty recognize object, people, sounds, shapes, etc.

A

agnosia

34
Q

inability to speak

A

aphasia

35
Q

inability to read

A

alexia

36
Q

inability to write

A

agraphia

37
Q

difficulty swalowing

A

dysphagia

38
Q

slurred speach

A

dysarthria

39
Q

inability to attend to one side of body

A

hemispatial neglect

40
Q

inability to perform specific task

A

apraxia

41
Q

unawareness or denial of existance of disability

A

anosognosia

42
Q

difficutly recall words or names

A

anomia

43
Q

unsteady gait

A

ataxia

44
Q

middle cerebral artery syndrome

A

C/L hemiplegia - face and upper extremities

C/L homonymous hemianopia

dominant - aphasia, alexia, agraphia, acalculia

non-dominant - hemineglect, dressing apraxia, anosognosia

45
Q

posterior cerebral artery syndrome

A

homonymous hemianopia, alexia without agraphia - can’t read - can write**
visual or color anomia

46
Q

lateral pontine syndrome

A

marie foix syndrome
anterior inferior cerebellar a

ataxia - arm and leg
weak upper and lower extremity
hemisensory loss - pain and temp

47
Q

lateral medullary syndrome

A

wallenberg syndrome
posterior inferior cerebellar a

facial sense loss/pain
ataxia
nystagmus
vertigo
hoarse
dysphagia
horner syndrome**
hemisensory loss
hiccups
48
Q

locked in syndrome

A

quadriplegia, B/L facial paralysis, dysarthria

49
Q

ventral pontine syndrome

A

raymond syndrome

  • lateral gaze weakness
  • C/L hemiplegia
50
Q

millard-gubler syndrome

A

ventral pontine syndrome

  • C/L upper/lower extremity weak
  • C/L hemiplegia
51
Q

ataxic hemiparesis

A

C/L upper/lower extremity weakness and ataxia

52
Q

anton syndrome

A

cortical blindness

blindnes and denial

53
Q

amaurosis fugax

A

temporary one eye blindness

warning sign of stroke

embolic - carotid artery

also - hemodynamic, ocular, neuro, idiopathic

54
Q

TIA

A

stroke lasts less than 24 hours

10% risk of CVA within first 3 months

55
Q

diagnosis of stroke

A

neuro and mental status exam

CT without contrast
MRI - very sensitivte

56
Q

CT and stroke

A

to rule out bleeding - so can give clot buster or not

57
Q

lower face only affected

A

with central bells palsy - CN VII

58
Q

tx of stroke

A

acute tx
primary stroke prevention
secondary stroke prevention

59
Q

acute tx of stroke

A

rtPA and aspirin

IV fluid - keep BP sufficient for saving penumbra

swallowing eval

early rehab

60
Q

non-modifiable stroke risk fx

A 
age
fam hx
race - AA and hispanics
gender - men
med hx
61
Q

modifiable stroke risk fx

A 
HTN
A-fib
smoking
DM
carotid stenosis
hyperlipidemia
obesity
alcohol/drug use
62
Q

stroke prevention

A

diet
exercise
control BP, blood sugar, cholesterol

quit smoking

63
Q

stroke prevent meds

A

aspirin
clopidogril
ASA, dipyridamole

warfarin, heparin, LMWH

Neuro II Exam 2 (20 decks)

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