Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

How common is stroke?

A
  • most common cause disability

- 4th leading COD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lifetime cost of ischemic stroke

A

$140k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MC type of stroke

A

87% are ischemic, usually cerebral thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two types of ischemic stroke

A
  • thrombotic

- embolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Two types of hemorrhagic stroke

A
  • SAH (in skull around brain)

- intracerebral (in brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Four layers of vessel

A

lumen –> endothelium –> SM –> adventitia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Unmodifiable risk factors for stroke: (5)

A
  • 65+ years old
  • african americans
  • previous
  • female
  • family hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Preventable risk factors for stroke: (7)

A
  • HTN
  • DM
  • Tobacco
  • Afib, carotid disease
  • previous
  • obesity, inactivity
  • hypercholesterolemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Secondary blood disorders contributing to stroke risk:

A
  • high RBCs

- sickle cell anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Genetic risk factors for stroke: (5)

A
  • FV Leiden,prothrombin
  • ^ApoE4, homocysteine
  • Fabrys
  • ED
  • Pseudoxanthoma elasticum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute Neuroimaging during stroke alert:

A

1) CT
2) fast brain MRI
3) conventional angio
4) carotid US
5) transcranial dopplers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CTP evaluates for? How?

A
  • core/penumbra

- penumbra has preserved blood volume (CBV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define MTT:

A
  • mean transit time

- increased in areas of brain distal to vessel occlusions (penumbra + core)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define CBV:

A
  • cerebral blood volume

- preserved in penumbra, decreased in core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Compare recanalization of vessels in penumbra v core:

A
  • May be beneficial in penumbra

- risk for more ADRs than benefit in core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Timing for tPA administration

A
  • FDA: 3 hours

- ASA: 3-4.5 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ASA dose for stroke pts:

Who recieves ASA?

A
  • 325 mg
  • do not recieve tPA
  • 24 hours after tPA if no hemorrhage present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When are benefits of tPA seen?

A

-tPA better than ASA at 90 days out, 24 improvement no different

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In addition to 3 hr window + CT free of hemorrhage, what must be true of pt to consider tPA?

A
  • measurable deficit on NIH stroke scale

- patient 18+ years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What “conditions” are absolute CIs to tPA? (5)

A
  • stroke/ trauma within 3 months
  • GI/GU hemorrhage within 21 days
  • surgery within 2 weeks
  • artery puncture within 1 wk
  • history of ICH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What blood pressures are absolute contraindications to tPA?

A

-185/110 after efforts to manage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What symptoms are absolute contraindications to TPA?

A

-sx suggestive of SAH even with clear CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What bleding conditions are abs contraindications to TPA?

A
  • heparin + elevated PTT w/in last 48 hours
  • PT higher than 15 s
  • INR higher than 1.7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Platelet count CI in TPA?

A

-less than 100k uL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What glucose is abs CI in TPA?
- less than 50 | - higher than 400
26
Four "relative" CI to TPA?
- large/MCA stroke - sx are minor or rapidly improving - seizure at onset of stroke - aggressive tx needed to meet BP goals
27
FDA approved method of TPA administration
systemic IV dosing
28
Cushings triad
- HTN - brady - irregular respirations
29
Three symptoms specific of Anterior circulation stroke
- gaze preference - aphasia - neglect
30
Four symptoms specific for posterior circulation stroke
- vertigo - diplopia - crossed track findings - dysconjugate gaze
31
Four symptoms that may be seen in either anterior or posterior stroke
- hemiparesis, anesthesia - visual field deficit - slurred speech - ataxia
32
Symptom specific to dominant hemispheric strokes:
1) dominant: aphasia | 2) nondominant: neglect, apraxia
33
Cause of akinetic mutism
Bilateral ACA strokes
34
Cause of Antons Syndrome + What is antons syndrome
- bilateral PCA strokes | - cortical blindness
35
mesial temporal lobe infarct affects what structures?
-limbic
36
MC Cause of AMS assc with stroke
-Aphasias
37
How common is symptomatic ICH following IV TPA?
6.4% of patients
38
4 risk factors for ICH following tPA
- older - previous stroke - small vessel ischemia - labile BP
39
How can emboli reach the brain?
- heart: afib, valve disease, PFO | - carotid stenosis
40
Visual defect assc with left sided MCA stroke?
- loss of the rt visual fields | - eyes look towards lesion
41
Speech is controlled by the same side of the brain as:
handedness | right hand dominant, left brain dominant language
42
3 classic ACA infarct symptoms
- leg more than arm weakness - personality or cognitive defects - urinary incontinence
43
Limb ataxia is assc with stroke of what artery?
-PCA (per master the boards, Kaplan) (per Nolte, can be anterior OR posterior circulation...)
44
How soon does CT show stroke? MRI? Why is CT done acutely?
- CT: 4-5 days to reach 95% sensitivity - MRI: 24-48 hrs - CT done acutely to exclude hemorrhage
45
What characterizes nonhemorrhagic stroke on CT?
-edema without blood (may see midline shift, ventricular compression)
46
If ischemic stroke patient is already taking aspirin at time of symptom onset, what is the next best anticoagulant option? (assuming pt is not tpa candidate or has already received is a day ago)
- add dipyridamole | - switch to clopidogrel
47
Treatment for TIA
aspirin +/- dipyridamole OR clopidogrel
48
Treatment for hemorrhagic stroke
- none | - may surgically drain only if limited to posterior fossa
49
If tPA is given within 3-4.5 of sx onset, what is required?
-written consent, this time period is not FDA approved and is considered experimental
50
In addition to being anticoagulated, every patient with a stroke should take?
STATINS
51
LDL goal for stroke patients?
-70-100
52
Appearance of blood on CT
bright white hyperdense lesion
53
Treatment of thrombi throwing clots to brain:
-heparin --> warfarin
54
Goal INR for pt with hx of embolic strokes
2-3
55
How is afib treated to prevent stroke?
-heparin --> warfarin to INR of 2-3
56
Workout to evaluate causes of stroke?
- echo - EKG (telemetry, holter) - Carotid US
57
When is carotid endarterectomy advised?
70%-90% stenosis | **Cannot intervene is blockage is 100% occluded.
58
Endarterectomy vs carotid angioplasty and stenting: which is superior?
-endarterectomy, stenting is of no proven value to stroke patients
59
4 risk factors to control for stroke prevention
- HTN - keep a1c under 7 - reduce LDL to under 100 - smoking cessation
60
Definition of TIA
sx resolve within 24 hours
61
Two main pathways resulting in cellular death from stroke:
- necrosis (energy failure, cell swelling) | - apoptosis (penumbra over days)
62
PCA #1 defect
-contralateral visual field cut
63
Signs of lacunar infarct:
-motor/sensory deficit WITHOUT cortical signs
64
Signs of basilar artery stroke
crossed face and body findings + oculomotor deficits
65
Signs of vertebral artery stroke
crossed face and body findings + lower cranial nerve deficits
66
Define: anosognosia
unawareness of illness and its clinical manifestations | similar to insight?
67
MC cause neglect (2)
-right MCA territory stroke (non-dominant parietal lobe, premotor cortex of frontal lobe)
68
Why must be determined before diagnosing apraxia
-pt understands the command, is cooperative, and has learned the task
69
Deficit assc with stroke of dominant occipital cortex/adjacent corpus callosum
agnosia: visual information disconnected from language centers - patient cannot read own writing, has color agnosia
70
# Define: - asomatognosia | - prosopagnosia
- asomatognosia: does recognize body as part of own (Mrs. Mayo) - prosopagnosia: cannot recognize faces
71
Labs drawn during Stroke Alert (4)
- CBC - CMP - PTT - INR
72
How long should imaging take during code stroke?
-CT + CTA less than 10 minutes
73
MRI sequence needed for for assessing stroke?
DWI (intense in stroke)
74
TPA MOA
-binds fibrin, converts plasminogen to plasmin
75
How common is hemorrhage in TPA administration?
-6-7%; 1/16
76
Large artery strokes are often _____ while lacunar infarcts are _____.
large: embolic lacunar: HTN related

Neuro (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions