Acute stroke managment

Question 1

stroke risk with age

Answer 1

doubles every deade after 55

Question 2

def of stroke

Answer 2

clinical syndrome of sudden onset focal neuro deficift presumed to be due to vascular

Question 3

4 questions for stroke diagnosis

Answer 3

1. is it stroke?
2. where is lesion
3. type of lesions (ischemia Vs. hemmorage
4. what is etiology

Question 4

5 steps if stroke diagnosis

Answer 4

1. Hx and exam
2. labs (CXR, INR, CBC, HBA1C)
3. image brain
4. image vessels
5. rule out cardiac source

Question 5

5 stroke mimics

Answer 5

1. any focal lesion (tumor, demylenations)
2. post ictal
3. old stroke
4. hysterical conversions
5. migraine

Question 6

def of TIA

Answer 6

sudden onset of focal neuro that resolve within 24 hours AND no evidence of infarct on imaging

Question 7

5 signs of carotid stroke

Answer 7

1. retinal ischemia
2. aphasia
3. cortical sensory loss
4. apraxia
5. sensory motor deficit

Question 8

5 signs of verti-basilar

Answer 8

1. diploplia
2. coma
3. crosss sensory loss
4. bilateral motor signs
5. isolated field defect

Question 9

what are prevalence of stroke types

Answer 9

1. 80 ischemic
2. 10 sub arach
3. 10 into parenchyma

Question 10

*** what shows on CT in 2 types

Answer 10

hemor- shows blood

isch - very subtle

Question 11

what are only 3 wihte things on CT

Answer 11

1. blood
2. contrast
3. calcified tissues

Question 12

5 goals in acute isch stroke mgmt

Answer 12

1. make rapid and acc. diagnosis
2. reduce infarct size
3. avoud secondary complications - sepsis, embolism
4. secondary prevention
5. educate and rehab

Question 13

what happens as ischemis prgresses

Answer 13

synaptic failure>membrane failure

Question 14

what is penumbra

Answer 14

area that can still be saved around the infarct

Question 15

what is treatment window

Answer 15

4.5 hours

Question 16

what are physical neuroprotection measures

Answer 16

1. hypothermia

2. avoid hypotension, hyperglycemia, fever

Question 17

drugs to retard ischemic cascade

Answer 17

1. gluatmate antag.
2. free radical scavengers
3. NO synthase antag

Question 18

what is risk of TPA

Answer 18

hemmorage

Question 19

what is TPA NNT

Answer 19

10

Question 20

4 primary stoke risk factors

Answer 20

1. hypertensiokn
2. diabetes
3. dyslipidemia
4. smoking

Question 21

what is risk of stroke post -TIA

Answer 21

90 days ~ 10%

Question 22

5 possible secondary preventions

Answer 22

1. antiplatelets
2. anticoagulants
3. carotid endartectomy
4. carotid angio

Question 23

4 signs of stroke that can be mixed

Answer 23

1. dysarthia
2. dysphagia
3. pure motor
4. pure sensory