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ESA 5 - Integrative > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a stroke?

A

A sudden onset of focal neurological deficit with a vascular cause

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2
Q

What are the two types of stroke?

A

Ischaemic

Haemorrhagic

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3
Q

What are the two broad categories of stroke risk factors?

A

Modifiable

Non-modifiable

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4
Q

What are some modifiable risk factors of stroke?

A 
BP
Diabetes
High cholesterol
Smoking
Excess alcohol
Obesity/lack of exercise
AF
Hypercoaguable states
Drug abuse (e.g. cocaine)
Infections
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5
Q

What are some non-modifiable risk factors of stroke?

A

Male gender
Increasing age
Family history
Ethnicity

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6
Q

What term is given to a stroke with no identifiable cause?

A

Cryptogenic stroke

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7
Q

Cryptogenic strokes account for what percentage of the total number of strokes?

A

10%

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8
Q

What are the causes of ischaemic stroke?

A

Thrombus in situ (atheroma) i.e. small vessel disease

Embolic

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9
Q

Where can emboli originate to cause an ischaemic stroke?

A

Heart (e.g. in AF)

Large arteries (neck or aortic arch)

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10
Q

What is the main treatment for patients with an ischaemic stroke?

A

Thrombolysis

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11
Q

At best what percentage of stroke patients are eligible for thrombolysis?

A

15%

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12
Q

What aspect of stroke treatment is as important as (if not more than) thrombolysis?

A

Good MDT care on a specialist stroke unit

Physiological parameter control

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13
Q

What is used in thromobolysis?

A

rTPA

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14
Q

What does rTPA stand for?

A

Recombinant Tissue Plasminogen Activator

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15
Q

In what time frame post-stroke can rTPA be administered?

A

0-4.5 hours

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16
Q

What ‘age’ is looked at when considering thrombolysis?

A

Biological age i.e. how well functioning is the person pre-stroke rather than their actual age

17
Q

Over what age is thrombolysis technically used ‘off-licence’?

A

80

18
Q

How is rTPA administered?

A

0.9mg/kg - 10% as a stat bolus then the rest over 60 mins

19
Q

What is a new treatment for ischaemic stroke?

A

Thrombectomy

20
Q

In what timescale post-stroke can thrombectomy be performed?

A

6 hours

21
Q

What is a third treatment option for ischaemic stroke?

A

Craniotomy

22
Q

Does craniotomy have good outcomes?

A

No - stops death but can often leave the patient with disability

23
Q

What are the secondary prevention options for ischaemic stroke?

A

Anti-thrombotic therapy (antiplatelets)/Anticoagulation

BP control

Lipid lowering

Blood sugar control

Lifestyle changes

Carotid endarterectomy

24
Q

Risk of a cardio-embolic stroke should be treated with what type of medication?

A

Anti-coagulation

25
Q

What drugs can be used for anticoagulation?

A

Warfarin

DOACs

26
Q

Why are DOACs easier to use?

A

The dose is consistent so better for elderly patients

27
Q

What are the causes of a haemorrhagic stroke?

A

Primary bleed usually due to hypertension

Secondary to anticoagulation

Underlying vascular abnormality

Underlying tumour

Cerebral amyloid angiopathy

28
Q

What should be done if a patient on anticoagulation has a haemorrhagic stroke?

A

Reverse anticoagulation

29
Q

What secondary prevention is used in haemorrhagic strokes?

A

BP control

Exclusion of underlying causes

30
Q

What are the symptoms of stroke dependent on?

A

The blood vessels and subsequently the areas of the brain affected

31
Q

What are the symptoms of TACS (Total Anterior Circulation Stroke Syndrome)?

A

Hemiparesis

Hemisensory loss

Hemianopia

Higher cortical dysfunction

32
Q

What are the symptoms of PACS (Partial Anterior Circulation Stroke Syndrome)?

A

Two of symptoms of TACS or higher cortical dysfunction in isolation

33
Q

What are the symptoms of LACS (Lacunar Stroke Syndrome)?

A

Pure motor

or

Pure sensory

34
Q

What is a POCS (Posterios Circulation Stroke Syndrome)?

A

Posterior circulation event

35
Q

What is the usual cause of a TACS?

A

Cardiac emboli

36
Q

What is the usual cause of a PACS?

A

Large vessel disease

37
Q

What is the usual cause of a LACS?

A

Small vessel disease

38
Q

What is the usual cause of POCS?

A

Can be anything

ESA 5 - Integrative (10 decks)

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