stroke

Question 1

What is defined as a clinical syndrome consisting of disturbance of cerebral function lasting longer than 24 hours or leading to death?

Answer 1

Stroke

A stroke can be ischaemic or haemorrhagic.

Question 2

What does TIA stand for, and how does it differ from a stroke?

Answer 2

Transient Ischemic Attack

TIA has the same signs and symptoms as a stroke but resolves within 24 hours.

Question 3

What assessment tool can be used to identify signs of a stroke?

Answer 3

FAST

FAST stands for Facial weakness, Arm weakness, Speech problems, and Time to call 999.

Question 4

What does the ‘F’ in FAST stand for?

Answer 4

Facial weakness

Ask the patient to smile.

Question 5

What does the ‘A’ in FAST stand for?

Answer 5

Arm weakness

Ask the patient to raise both arms above their head.

Question 6

What does the ‘S’ in FAST stand for?

Answer 6

Speech problems

Ask the patient to repeat a sentence.

Question 7

What does the ‘T’ in FAST stand for?

Answer 7

Time to call 999

Note the time when symptoms first appeared.

Question 8

What is the ROSIER scale used for?

Answer 8

To assess the possibility of stroke

A score greater than 0 indicates a possibility of stroke.

Question 9

What is the first pharmacological management step for suspected TIA?

Answer 9

Offer aspirin 300mg daily

This is for suspected TIA management.

Question 10

What should be done for patients with suspected TIA?

Answer 10

Refer for specialist assessment within 24 hours

This is crucial for timely intervention.

Question 11

What should be performed for patients admitted with an acute stroke?

Answer 11

Non-enhanced CT scan

This is for specific indications like thrombolysis eligibility.

Question 12

What is the time frame for initiating thrombolysis with alteplase?

Answer 12

Within 4.5 hours of symptom onset

It’s essential to exclude hemorrhage before thrombolysis.

Question 13

What medication should be commenced for acute stroke management after thrombolysis?

Answer 13

Aspirin 300 mg once daily for 14 days

An alternative antiplatelet can be used if allergic to aspirin.

Question 14

What is the recommended long-term medication after an acute stroke?

Answer 14

Clopidogrel 75 mg once daily

This is preferred unless the patient has atrial fibrillation.

Question 15

What lifestyle factor is important in secondary prevention of stroke?

Answer 15

Control of modifiable risk factors

Pharmacists can help monitor factors like blood glucose.

Question 16

True or False: Statins are recommended for acute stroke patients.

Answer 16

False

Statins are not recommended during the acute phase.

Question 17

What is crucial for managing patients with diabetes post-stroke?

Answer 17

Control of blood glucose concentration

Effective blood glucose management is essential.