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Flashcards in CVA Deck (16)
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1
Q

risk factors for stroke

A
  • age
  • previous TIA/stroke
  • hypertension
  • hypercholesterolaemia
  • atrial fibrillation
  • heart disease (ischaemia, valvular, carotid artery_
  • smoking and alcohol
2
Q

Characteristics of TACI

A
  1. higher cerebral dysfunction
  2. hemianopia
  3. ipsilateral motor or sensory deficit
3
Q

characteristics of PACI

A

2 of the following

  1. higher cerebral dysfunction
  2. hemianopia
  3. ipsilateral motor or sensory deficit
4
Q

characteristics of POCI

A

One of

  1. cerebellar or brainstem symptoms (ataxia, dysdiadokinesis)
  2. loss of consciousness
  3. isolated homonymous hemianopia
5
Q

characteristics of LACI

A

either

  • pure motor stroke
  • pure sensory stoke
6
Q

Management of acute stroke

A
  1. ABCD
  2. straight to CT to exclude haemorrhage
  3. if within 4.5hrs and no contraindications give IV thrombolysis
  4. if >4.5hrs 300mg Aspirin
  5. if haemorrhae benefit from surgical decompression and BP lowering
7
Q

what are the other features of stroke managed in a stroke unit

A
  • swallow assessment within 4hrs
  • normalise blood sugars
  • iv paracetomal to reduce temp
  • oxygen if hypoxic
  • image carotids once stable
8
Q

VTE prophylaxis in acute stroke?

A

s/c heparin is contraindicated acutely in stroke
TEDs are contraindicated
ensure pt is hydrated and avoid smoking

9
Q

risk stratification in TIA

A

Age >60
BP > 140/90
Clinical features- 1 point for dysphasia and 2 for hemiparesis
Duration of sx 1 point if >10mins, 2 points if >60mins
D2- diabetes

10
Q

secondary prevention after TIA/stroke

A
  • clopidogrel 75mg (first line)
  • Aspirin 75 mg - can give both if severe stenosis otherwise its second line
  • atorvastatin
  • antihypertensives- perindopril or indapamide
  • control vascular risk factors
11
Q

when is carotid endartectomy undetaken?

A

used if >50% internal carotid artery stenosis on the symptomatic side

12
Q

risk stratification in AF

A

CHADSVASC score

  • congestive heart failure (1)
  • Hypertension >140/90 (1)
  • age >75 (2) 65-74 (1)
  • diabetes (1)
  • stroke/tia/VTE (2)
  • vascular disease (1)
  • sex female (1)
13
Q

management of high risk AF patients

A
  • anticoagulation with warfarin (target INR 2-3)

- if contraindicated aspirin 75-300mg

14
Q

signs of an impaired swallow

A
dribbling
facial weakness
coughing/choking after swallow
food regurgitation
recurrent chest infections
15
Q

what is first line management of impaired swallow

A
  • NBM
  • temporary NG tube
  • await SLT assessment
16
Q

imaging techniques to assess swallow

A
  • video fluoroscopy

- fibre optic endoscopic examination of swallow