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Flashcards in 6.4 Stroke & TIA Deck (47)
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1

What is another condition that can present as if a patient has had a stroke?

Hypoglycaemia.

2

What is the ABCD2 score used for?

ABCD2 is a way of assessing the risk to a patient of subsequently developing a stroke following a TIA.


3

What is a TIA?

Transient Ischaemic Attack.

Defined as stroke symptoms or signs that completely resolve within 24 hours.

4

How does the ABCD2 score work?

A way of assessing the risk of a patient developing a stroke following a TIA.

It is based on a point system where Age, Blood Pressure, Clinical Features and Duration of symptoms are given points and the total of these are used to assess risk to patient.

5

What are the letters ABCD2 abbreviated for?

Age
Blood pressure
Clinical features
Duration of symptoms

6

If a patient has an ABCD2 score > 3 (greater than 3) what is their risk status?

Medium to high risk.

7

What is your treatment plan for a patient with an ABCD2 score greater than 3?


Recommendation to transport to hospital.

Patient is at immediate to high risk

8

What is the risk determination of a patient with an ABCD2 score less than or equal to 3?


Patient is at low risk.

9

What is the treatment plan for a patient that has had a TIA and has an ABCD2 score less than or equal to 3?


Refer patient urgently to a TIA clinic (if one available) and if a TIA clinic is not available the patient should receive a recommendation to transport to hospital.

10

True or False ....The higher the score on an ABCD2 test the lower the risk?

False

11

ABCD2 score - how many points awarded for the following?
Age if patient is greater than or equal to 60 years old?

1 point

12

ABCD2 score - how many points awarded for the following?

Blood pressure if patient has a SBP > 140 and/or DPB > 90?

1 point

13

ABCD2 score - how many points awarded for the following?
If duration of symptoms have lasted more than or equal to 60 minutes.

2 points

14

ABCD2 score - how many points awarded for the following?
If duration of symptoms have 10 - 59 minutes.

1 point

15

ABCD2 score - how many points awarded for the following?
If duration of symptoms have lasted less than 10 minutes?

0 points

16

Is diabetes used as an assessment factor in the ABCD2 score?

Yes - if a patient has diabetes present they get 1 point?

17

If assessing a patient using the ABCD2 score, and they have diabetes, how many points are allocated?

1 point

18

If a patient has a TIA is there a chance they can develop a stroke?

Yes

19

ABCD2 score - how many points awarded for the following?
If clinical features show unilateral weakness?

2 points

20

ABCD2 score - how many points awarded for the following?
If clinical features show speech disturbance without weakness?



1 point

21

Which of the following two types of stroke are most likely candidates for thrombolysis?

Ischaemic or Haemorrhagic?


Ischaemic within 3.5 hours of symptom onsets if hospital has a CT scanner.

22

How do you distinguish between a ischaemic and haemorrhagic stroke?

At hospital with a CT scan.

23

Define what the FAST test is.

An assment tool is a patient is suspected of having had a stroke.

Checking Face, Arms and Speech for unilateral weakness and assessing the length of time a patient was last seen as normal.

24

In the FAST test what do you do to assess the Face for unilateral weakness?

Look for new onset of unilateral weakness.

Ask the patient to smile, show their teeth or gums.

25

In the FAST test what do you do to assess the Arms for unilateral weakness?

Look for new onset of unilateral weakness.

Ask the patient to raise their arms, palms facing upwards, to 90 degrees. Then close their eyes and hold them there for 5 seconds - look for one arm to drift downwards.
Ask the patient to walk. Look for abnormal gait.

26

In the FAST test what do you do to assess the Speech for unilateral weakness?

Look for new onset of abnormal speech.
Ask the patient to repeat a sentence - look for slurring.
Ask the patient to name common objects - look for difficulty or inability to name them.

27

What are the criteria for transporting a stroke patient to hospital by helicopter? Hint there are 4.

1. Patient must be under 70 years and
2. Patient must have significant weakness and
3. patient can reach hospital within 3.5 hours from onset of symptoms and
4. Helicopter transport will save more than an hour compared to road.



28

True or False....Patients who have had an ischaemic type of stroke are usually able to obey commands on their "good side"?

True

29

Is there any circumstance where you would transport a stroke patient to their GP rather than hospital?

No - GP only for backup perhaps.

30

A person having a haemorrhagic stroke may, along with unilateral weakness, also present with another two symptoms - what are these?

sudden onset headache.
inability to obey commands on "good side"

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