Exam 3 Cerebrovascular Dz Management Flashcards Preview

Q4 Clin Med III (GI) > Exam 3 Cerebrovascular Dz Management > Flashcards

Flashcards in Exam 3 Cerebrovascular Dz Management Deck (17):
1

Goals of stroke therapy? (3)

Address acute event
Prevent toxic cascade
Prevent recurrence

2

Stroke studies? (6)

Angio
Carotid US
Cranial CT
ECG
Echo
MRI/MRA

3

Acute mgmt of CVA?

ABC
Control BP
Avoid hypotonic fluids (D5W)
ASA 325mg/day

4

Management of BP during CVA, when?

How?

Want how much of a drop?

What med is contraindicated?

if >200/100

DOC = IV Labatolol

NOT more than 20%

SL procardia

5

Cranial CT done why?

MANDATORY to r/o hemorr stroke

6

Rapid assessment of stroke/CVA should include?

What studies? (4)

Focused hx/physical

Pulse Ox
ECG
CXR
Cranial CT

7

Rapid assessment of stroke/CVA labs should include? (7)

CBC/platelets
CMP
PT/PTT
ESR
Tox screen w/ blood etoh
Preggo test
Blood type

8

Stroke/CVA coagulation addressed how?

Assess for recombinant tissue-type plasminogen activator (rt-PA)

If not rt-PA ok, Heparin/Warfarin

9

rt-PA contraindicated when? (7)

Uncontrolled HTN (>185-110)
Head trauma w/i 3 mo
Intracranial hemorr hx
Gi or GU hemorr w.i 3 wks
Major surgery w/i 2 wks
Anticoag therapy or coagulopathy hx
Preggos

10

Heparin loading dose?

Goal?

5000 units

Maintain PTT @ 1.5 x control

11

Warfarin dosing?

Goal?

2-10 mg/day

INR 2-3

12

Anti-platelet meds used when? (2)

Small vessel dz
Hx of Transient Ischaemic Attack (TIA)

13

Anti-platelet meds? (4)

ASA
Ticlopidine (Ticlid)
Clopidogrel (Plavix)
Warfarin if others fail

14

Statins used when?

Acute phase of stroke after IV thrombolysis

15

Tx for Intra-arterial Thrombolysis?

Small dose of rt-PA into clot

16

Carotid Dz indications for surgery?

Surgery type?

Goal?

Lesions causing >70% stenosis

Carotid Endarterectomy

↓ risk of stoke

17

Carotid Angioplasty/Stents indicated when? (5)

High-risk pts:

High lesion
Prior neck dissection
Unstable angina
Recent MI
HF