Clinical Aspects Stroke-Lopez Flashcards
(40 cards)
What is the risk of a stroke (ischemic) following a TIA?
Annual risk of stroke after a TIA is 3-4%
What is a TIA?
Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia. w/o acute infarction
Most TIAs last 15 minutes
If the symptoms last hours, more likely than not there will be infarcted tissue
What is a stroke?
Brain , spinal cord, or retinal cell death attributable to ischemia, based on pathological, imaging, and/or clinical evidence of permanent injury
Silent infarction produces no symptoms
How do you classify an ischemic stroke?
Large Vessel Small Vessel Cardioembolic Other known pathology Unknown cause
What are the non-modifiable stroke risk factors for strokes?
Age Low birth weight Ethnicity Black Some Hispanics Higher incidence of all stroke types Higher mortality rates Genetics/family history
How does a family hx of stroke increase the risk of stroke in you?
increases it by 30%
At what age are you concerned if a family member has had a stroke?
esp concerned for familial factors if family member had stroke before age 65
What are 2 non modifiable genetic risk factors for aneurysms?
8% individuals w AD polycystic kidney disease
7% individuals w cervical fibromuscular dysplasia
Pt has a hx of 2 first degree relatives w/ subarachnoid hemorrhages or intracranial aneurysms. What might be an appropriate plan of action?
non-invasive screening for un-ruptured intracranial aneurysms
Pt has polycystic kidney disease and hx of subarachnoid hemorrhage. What might be an appropriate plan of action?
non-invasive screening to monitor
Pt has more than 1 relative with polycystic kidney disease & intracranial aneurysm. What might be an appropriate plan of action?
non-invasive screening to monitor
What are some modifiable risk factors for stroke?
Mostly related to lifestyle Physical inactivity Dyslipidemia HTN Diabetes Diet Obesity
What is the mortality difference b/w active people & inactive people? Routine is important.
Active people have 25-30% lower mortality than least active.
Why is physical activity so beneficial?
Reduces plasma fibrinogen
Reduces platelet activity
Elevates t-PA activity
Elevates HDL
How much should an adult exercise each week?
3-4 days/weeks
40 minutes
moderate-vigorous intensity exercise
Why are statins sometimes beneficial?
lowers LDL
decreases stroke risk for patients who have high risk of atherosclerosis
may even improve the plaque characteristics.
Each 1% reduction in total cholesterol corresponds to ___% reduction in risk of stroke.
0.8%
Pt has a high 10 yr risk of cardiovascular event. What is recommended?
Lifestyle changes.
Statin
T/F The use of niacin and fibric acid derivatives are equally effective as statins in preventing cardiovascular events.
False. The effectiveness of these treatments are not proven.
Which ethnicity is particularly susceptible to the high sodium intake and low potassium intake and a just bad diet?
African Americans
Which dietary intake has been associated with a lower risk for strokes?
fruits & vegetables
increased intake of flavanoids-primarily from citrus fruits
T/F Red meat intake causes an increase in healthy protein and therefore a reduced risk for stroke.
False. Increased risk of stroke.
T/F High sodium and low potassium is recommended diet to prevent strokes.
False. Low sodium, high potassium.
What is an ideal diet to prevent strokes?
mediterranean style diet
high fruits, veggies, nuts
low fat dairy
reduced saturated fats
