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Flashcards in [stroke] Deck (41)
1

[stroke]: Stroke causing cardiac emboli (30% of strokes) can be caused by what 4 heart conditions

Endocarditis
AF
MI
Prosthetic valves

2

[stroke]: Where in the brain does a 'watershed/boundary zone' stroke occur (not a brain area )

Infarct in the area between the supply of two arteries (i.e. decreased blood supply).

3

[stroke]: When does a 'watershed/boundary zone' stroke occur

Sharp drop in BP (sepsis)

4

[stroke]: Presenting >40yrs with migraine, TIA and mood swings is the main genetic cause of stroke. What is this called.

CADASIL

5

[stroke]: What does CADASIL stand for

Cerebral autosomal dominant arteriopathy with subcortical infarcts & leucoencephalopthy

6

[stroke]: What gene is responsible for CADASIL

NOTCH3

7

[stroke]: Fibromuscular dysplasia or neck trauma may cause stroke by spontaneous .... dissection

Carotid artery

8

[stroke]: Name 4 modifiable risk factors which are non-obvious

Carotid bruit
high homocysteine
Syphilis
increased clotting

9

[stroke]: Name the 2 places other than cerebral where infarcts can occur

Lacunar
Brainstem

10

[stroke]: What would a lacunar infarct affect anatomically (4)

Basal ganglia
internal capsule
Thalamus
Pons

11

[stroke]: in a lacunar stroke what would indicate that something other than the thalamus has been affected

Consciousness/cognition is unaffected

12

[stroke]: Where would you suspect the infarct if the patient reported disturbances in vision or gaze.

Brainstem

13

[stroke]: Locked in syndrome is associated with infarct in which area

Brainstem

14

[stroke]: What is the acute (1hr) management of stroke in order of priority (mneumonic)

ABBC TNA

Airway
BP, pulse, ECG
Blood glucose (4-11)
CT/MRI (urgent)
Thrombolysis
NBM
Antiplatelet

15

[stroke]: If a patient has a stroke and has a high BP, in what 2 circumstances should you treat.

Aortic dissection
encephalopathy

16

[stroke]: Within what time should thrombolysis be given

4.5 hrs

17

[stroke]: What drug is used in thromobolysis if expert clinicians, not CIs and <4.5hrs are all present.

Alteplase (tissue plasminogen activator)

18

[stroke]: What are the non-numerical CIs for thrombolysis

Major infarct/haemorrhage on CT
Neuro-deficit
recent birth/surgery/trauma/uncompressible puncture
AVM/aneurysm
Previous CNS bleeds
Anticoagulants/
seizures

19

[stroke]: What is the INR cut-off which is a CI for thrombolysis

1.7

20

[stroke]: What is the BP cut-off which is a CI for thrombolysis

>220/130

21

[stroke]: What is the plts cut-off which is a CI for thrombolysis

<100

22

[stroke]: The basilar artery forms the .... arteries

post. cerebral

23

[stroke]: The internal carotid artery forms the ... and ... arteries

anterior cerebral
middle cerebral

24

[stroke]: What 2 parts of the cerebral cortex does the anterior cerebral artery supply

Medial
frontal

25

[stroke]: The medial and frontal cerebral cortices are concerned with contralateral ... and ... (if slightly milder)

leg
arm

26

[stroke]: If the legs of a patient are affected but the face is spared which artery is likely to be affected.

Anterior cerebral

27

[stroke]: Akinetic mutism describes a lack of movement and speaking. It can be caused by damage to the cingulate gyrus. .... is the location of the infarct.

Bilateral ant. cerebral artery

28

[stroke]: Contralateral hemiparesis/hemisensory loss, especially of face and arms indicates the ... is infarcted.

Middle cerebral

29

[stroke]: the middle cerebral artery supplies the optic radiation. What might and infarct cause.

Contralateral homonymous hemianopia.

30

[stroke]: Middle cerebral artery infarct on the dominant side of the brain is associated with ...

Dysphasia (disorder of language)

31

[stroke]: Middle cerebral artery infarct on the non-dominant side of the brain is associated with ...

visuo-spatial disorders (gets lost/ cannot dress)

32

[stroke]: Why with a posterior cerebral artery infarct do you get homonymous hemianopia with macular sparing

Macula receives collateral blood supply from the middle cerebral artery.

33

[stroke]: the brainstem is supplied by which arterial system

Vertebro-basilar (i.e. not carotid)

34

[stroke]: Damage to the ventral pons can be casued by infarct of which artery

Pontine

35

[stroke]: infarct of the pontine artery causes ... syndrome due to ischaemia of ventral pons.

Locked in

36

[stroke]: Ischaemia of the lateral medulla and the inferior cerebellum is caused by reduced flow through which 2 arteries

vertebral
posterior inferior cerebellar

37

[stroke]: How does lateral medullary syndrome present

vertigo
vomiting
dysphagia
ipsilateral ataxia
soft palate paralysis
ipsilateral horners
analgesia ipsilateral on face, contra on body.

38

[stroke]: What arteries are implicated in lateral medullary syndrome (2)

one vertebral
posterior inferior cerebellar

39

[stroke]: If BP differs by >20mmHg in each arm what might you suspect

subclavian artery stenosis

40

[stroke]: If brain ischaemia is related to use of the pts arm which syndrome might be present

Subclavian steal syndrome

41

[stroke]: Retrograde flow of blood down the vertebral artery into arm due to subclavian stenosis is called

Subclavian steal syndrome