CVA TIA, Pales I Flashcards Preview

Year 2 neuro exam 2 > CVA TIA, Pales I > Flashcards

Flashcards in CVA TIA, Pales I Deck (49)
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1
Q
incidence of strokes
A
1 every 40 seconds
2
Q
leading cause long-term disability in US
A
stroke
3
Q
CVA
A
cerbro vascular accident
abrupt onset neuro deficit that is attributable to focal vascular cause
4
Q
2 major types of stroke
A
hemorrhagic stroke
ischemic stroke
5
Q
What is the penumbra in ischemia
A
brain tissue around cerebral necrosis that has reversible changes
6
Q
main categories of causes of ischemic strokes
A
large artery thrombosis
embolism
lacunar
7
Q
what are the originations of embolisms that can cause ischemic strokes
A
arterial: carotid or aorta
heart: atrial, valve or ventricular
paradoxical
8
Q
what are the not common causes of stroke
A
watershed infarcts
hypercoagulable disorders
vasculitis
vasospasm
dissection of artery
9
Q
what happens in large artery thrombosis
A
activate platelets and coagulation that cause occlusion
10
Q
types of emboli that cause strokes
A
athersclerotic plaques and those from thrombi
11
Q
source for paradoxical emboli
A
lower extremity DVT
12
Q
atrial source of emboli
A
a fib, flutter
atrial septal aneurism
atrial tumors (myxoma)
13
Q
what is afib
A
fast and ineffective atrial contraction leading to stasis and thrombus formation
14
Q
atrial septal aneurysm
A
weakening and out-pouching of interatrial septum leading to stasis and thrombus formation (mural)
15
Q
most common tumor in atrium
A
atrial myxoma
16
Q
atrial myxoma
A
pieces of tumor may tear off and become emboli
associated thrombus can embolize artery down the stream
17
Q
emboli from ventricular source
A
cardiomyopathy
myocardial infarction
ventricular aneurisms
18
Q
majority of ventricular emboli are from what type
A
MI, stasis!
19
Q
how do MIs lead to emboli
A
part of wall not moving so creates stasis and leads to thrombus formation
20
Q
what can cause valvular sources of cardiac emboli
A
rheumatic mitral stenosis
prosthetic valves
infective and non-infective endocarditis
nonbacterial thrombotic endocarditis (malignancies and prothombotic states)
calcification of valves
bicuspid aortic valves
inflammatory valvulitis
21
Q
causes of inflammatory valvulitis
A
libman sacks endocarditis (assoc with lupus)
behcet disease
syphilis
22
Q
where to arterial embolic infarcts take place that affect brain
A
carotid artery atherosclerosis or stenosis
23
Q
what is defect that can lead to paradoxical embolie
A
patent foramen ovale
need Tx atrial septal defect
24
Q
lacunar infarcts occur where
A
subcortical areas of brain from small deep penetrating aa arising from big aa
25
Q
increases risk for lacunar infarcts
A
atheroemboli
or lipohyalinosis
26
Q
major factor lacunar infarct
A
HTN
27
Q
25% ischemic strokes are what type
A
lacunar infarcts
28
Q
Sx lacunar infarcts
A
frequently asymptomatic
29
Q
lipohyalinosis
A
high pressure of L arteries transmitted to small arteries
hyperplasia small vessels
hyalinization of vessel walls
narrowing then occlusion
30
Q
Watershed infarcts
A
ischemic infarcts of areas farthest from the large aa
most sensitive is when perfusion decreases
31
Q
watershed infarcts develop in what conditions
A
sepsis
severe bleeding
severe dehydration
32
Q
Where are the cortical border zones
A
between ACA and MCA
between MCA and PCA
33
Q
3 parts that normally control state of homeostatic equilibrium
A
coagulation system
anticoagulation system
thrombolytic system
34
Q
what leads to hypercoagulable states
A
promote coagulation over anti-coagulation
35
Q
hypercoagulable states clot what type vessels
A
veins more than arteries
36
Q
what are the hypercoagulable disorders
A
Factor V mutation
Protein C or S deficiency
antithrombin deficiency
plasminogen deficiency
prothrombin gene mutation
37
Q
what disorders are more likely to cause arterial clotting
A
antiphospholipid antibody syndrome
hyperhomocysteinemia
38
Q
what do you detect in antiphospholipid Ab syndrome
A
anticardiolipin Ab
Lupus anticoagulants
39
Q
hypercoagulable states from other processes
A
cancer
pregnancy
hormone replacement therapy
prlonged bed rest or immobility, heart attack, stroke
myeloproliferative disorders such as polycythemia vera or essential thrombocytosis
40
Q
vertebral dissection seen in what sport
A
golfing from cerebral dislocation
41
Q
causes of strokes not hypercoagulation
A
vasculitis
vasospasm
moyamoya disease
42
Q
vasospasms causing stroke seen in
A
subarachnoid bleeding, cocaine use
43
Q
moyamoya disease
A
poorly understood occlusive disease involving large intracranial aa
44
Q
stroke presentation depends on
A
size of affected vessel
area of brain supplied by affected vessel
45
Q
hemiparesis
A
weakness of one side of body
46
Q
hemiplegia
A
complete paralysis of one side of body
47
Q
homonymous hemianopsia
A
loss of vision in same visual field of both eyes
48
Q
acalculia
A
difficulty to perform simple math tasks
49
Q
agnosia
A
inability to recognize objects, persons, sounds, shapes or smells