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MS3 Neurology > Stroke > Flashcards

Flashcards in Stroke Deck (21)
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1
Q

What are the types of strokes?

A
  1. Embolic 2. Thrombotic (involves diseased vessels) 3. Hemorrhagic (subarachnoid or parenchymal)
2
Q

ACA feeds primarily

A

Feet and legs

3
Q

MCA feeds primarily

A

Arms, hands, face, speech

4
Q

PCA feeds primarily

A

vision

5
Q

Basilar and vertebral insufficiency leads to

A

Syncope

6
Q

Basilar infarct can lead to what syndrome?

A

Locked in syndrome

7
Q

What are signs of cerebellar infarct?

A

Dysdiadokinesia; Ataxia

8
Q

Why perform a non-contrast CT of the head?

A

Answers the question, “is this a brain bleed?”

9
Q

If a hemorrhagic stroke is diagnosed on CT, what are the neurosurgical options?

A

Clip Coil Craniotomy

10
Q

While waiting for neurosurgery to consult on a hemorrhagic stroke, what is your role?

A

Reduce BP; Control bleed with FFP

11
Q

After acute management of a stoke, what studies should be ordered?

A

EKG Echo Carotid Ultrasound

12
Q

What post stroke finding requires a heparin to warfarin bridge?

A

Thrombus found on echo

13
Q

What post stroke finding does not require a heparin to warfarin bridge?

A

Atrial fibrillation

14
Q

Stroke is a clinical diagnosis. If there is a question, order what study?

A

MRI

15
Q

What is the cutoff time for tPA?

A

3 hours from symptom onset

16
Q

What is the BP cutoff for tPA?

A

<180/<105

17
Q

Who can’t you tPA

A

Anyone with current bleed, like GI bleed; Anyone with hx of intracranial bleed; Anyone with recent surgery

18
Q

Do not give what blood thinner in an acute stroke setting?

A

Heparin Warfarin

19
Q

Why allow permissive BP in the setting of acute stroke management (w/o tPA)?

A

Up to 220/110; Allowing punumbra (area around the infarct) to be perfused

20
Q

What is the management of diabetes in the setting of acute stroke?

A

Tightly control sugar, <140

21
Q

If a patient has a stroke while on aspirin, what is the management in terms of antiplatelet therapy in the long term?

A

ASA + dipyrimidole OR clopidogrel for ASA intolerance