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Flashcards in 4 Stroke - Consultant Deck (26):
1

What is the difference between as stroke and a TIA?

TIA

2

Definition of stroke

A syndrome of rapidly developing clinical signs of focal disturbance of cerebral function
>24 hours
with no apparent cause other than vascular origin

3

What is the time frame to treat patients using rt-PA?

4.5h don't use except in selected patients

4

What are the two main causes of stroke?

Haemorhage
Clot (infarct)

5

What is the best way to diagnose type of stroke?

CT scan

(although this does not tell us the extent of damage of infarct as it evolves)

6

Post stroke what are our treatment aims? (2)

Secondary prevention
Rehabillitation

7

Factors increasing risk of stroke

Smoking
Lipids
BP
Hypertension
Diabetes
AF
Vascular disease
TIA
Alcohol
Physical inactivity

8

Does weight and diet change your risk of stroke

There is inconsistent evidence for this

9

Does weight and diet change your risk of stroke

There is inconsistent evidence for this

10

What causes AF?

The pacemaker isn't working properly, contraction is not in sink so the blood pools and clot forms

11

TIA differential diagnosis

fainting
epileptic seizure
migraine
hypo
vertigo
brain injury
neuroinfection

12

Is HRT associated with stroke?

Yes - take anyone off it if suspected of TIA

13

Action in suspected TIA?

14

ABCD score

Age > 60
BP systolic >140 diastolic >90
Clinical features: unilateral weakness (+2), speech disturbance (+1)
Duration of symptoms > 60min (+2) 10-59min (+1)
Diabetes (+1)

15

What is the ABCD scored used for?

Assess risk of stroke in TIA patients - used to see how soon they should be seen for treatment

16

Secondary prevention (6)

Antiplatelet
BP
Statins
Smoking

Carotid endartectomy for carotid stenosis
Anticoagulants for AF

17

What is the ABCD scored used for?

Assess risk of stroke in TIA patients - used to see how soon they should be seen for treatment

>4 within 24h

18

Secondary prevention (6)

Antiplatelet
BP
Statins
Smoking

Carotid endartectomy for carotid stenosis
Anticoagulants for AF

19

What is the long term management of stroke?

???? see workshop?

20

What is the long term management of stroke?

???? see workshop?

21

Post stroke should a statin be initiated?

Yes - 48 hours after - regardless of lipid levels

22

following stroke what is target BP?

23

What should not be used to treat BP post stroke

Beta blockers - unless indicated for another reason

24

Long term treatment of TIA - what antiplatelet is recommended?

Aspirin and MR dipridamole

25

Long term treatment post ischemic stroke - what anti platelet is recommended?

Clopidogrel

26

first line statin used post stroke

Atorvastatin