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CLIN MED II, NEURO > Stroke / CVA > Flashcards

Stroke / CVA Flashcards

1
Q

Types of stroke

A

Iscemic

Transient Ischemic Attack

Hemorrhagic (traumatic vs spontaneous)

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2
Q

Types of Hemorrhagic stroke

A

Traumatic

  • Epidural Hematoma
  • Subdural Hematoma

Spontaneous

  • Subarachnoid Hemorrhage > Berry Aneurysm
  • Spontaneous Intracerebral Hemorrhage
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3
Q

Most common type of stroke

A

Ischemic (87%)

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4
Q

Stroke, higher incidence for men or women?

A

Men, until age 75+ then women

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5
Q

3 pathologic processes that lead to ischemic stroke

A
  1. Thrombosis (2/3)
    (Common/Internal Carotids or Circle of Willis + branches)
  2. Embolism (1/3)
    (cardiac, artery-artery)
  3. Systemic Hypotension
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6
Q

Blood disorders associated w Ischemic stroke

A

Prothrombin gene mutation

Factor V Leiden

Sickle Cell

Infection / Inflammatory States (HIV, Cancer, Crohns)

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7
Q

Patient presenting w aphasia, agraphia, memory/behavior, gaze, motor/sensory might be what kind o stroke

A

Cortical Stroke (ischemic)

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8
Q

Patient presenting w predominantly motor deficits on opposite side (face, arm, leg) might be what kind of stroke

A

Subcortical Stroke (ischemic)

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9
Q

Patient presenting w occulomotor impairment, CN findings (facial, disphagia, nystagmus) might be what kind of stroke

A

Subcortical Brainstem Stroke (ischemic)

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10
Q

Patient presenting w profound nausea, vomiting, headache, double vision, imbalance, eye movements. OR COMATOSED.

A

Brainstem Stroke

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11
Q

Stroke that shows non-focal symptoms beyond 1 vascular territory, autonomic symptoms: tachy, sweaty, pallor

A

Hypoperfusion

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12
Q

Routine blood work for stroke

A

CMP
CBC + Platelet
PTT / PT / INR
ESR

Lipids
Glucose

Urinalysis

Drug Screen

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13
Q

3 infectious processes to be considered/ruled out w stroke

A

Syphilus
HIV
Lymes

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14
Q

Diagnostic imagine for stroke

A
  1. CT, acute phase. Differentiates ischemic from hemorrhagic
  2. MRI : better for acute ischemic
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15
Q

Gold Standard Angiography for stroke

A

Digital Subtraction Angiography

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16
Q

Angiography to order in stroke code if pt is intervention candidate

A

CTA - Computer Tomography Angiography

if kidney function is ok

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17
Q

Angiography to order in stroke if pt has poor kidney function

A

MRA - Magnetic Resonance Angiography`

18
Q

Acute management of stroke

A

ABCs (Airway, Breathing, Circulation)

STAT CT +/- CTA

IV Access

Check Anticoag status and Glucose

Manage BP, < 220 / < 110

(get timeline from pt / family)

19
Q

tPA for stroke?

A

Approved for use within first 3 hours of acute stroke

pts > 18yrs

stroke causing clinically significant neuro deficit

20
Q

Tx Stroke

A

tPA (if candidate, 3 hrs etc)

Thrombectomy / lysis if large vessel anterior

Antiplatelet therapy: ASA 325mg (or anticoag, if indicated)

Statin: Atorvastatin

21
Q

Antiplatelet vs Anticoag Tx stroke

A

Anitplatelet for Iscemic / TIA

Anticoag for Cardiac Emboli

22
Q

Hemorrhagic stroke Tx

A

control BP, determine cause, c/s NSU (ABCs, CT/A, LP, pain mgmt., rainbow labs,
ECG, C Enzymes, CXR,
TTE (transthoracic echo)

23
Q

Which cranial artery is known to cause epidural hematoma -hemorrhagic stroke

A

Middle Meningeal Artery

24
Q

CT shows lens shaped, convex bleed

A

Epidural Hematoma

25
Q

Lucid Intervals often seen in what kind of stroke

A

Epidural Hematoma

26
Q

Epidural Hematomas often caused by

A

Trauma

27
Q

Subdural hematomas are arterial or venous?

A

VENOUS

28
Q

CT shows Crescent shaped, concave, slow growing

A

Subdural Hematoma

29
Q

Subdural hematoma often caused by

A

Trauma

30
Q

Majority of Subaracnoid Hemorrhage due to

A

Ruptured saccular aneurysm

31
Q

TIA’s typically relate directly to which vessels

A

Carotid or Vertebral vascular distribution

32
Q

Stroke symptoms which resolve completely and result in no infarction of tissue

A

TIA

33
Q

Cardioembolic vs Non-cardioembolic TIA Tx

A

Cardioembolic: Anticoagulants

Non-cardioembolic: Antplatelet (Aspirin, Plavix)

34
Q

Accumulation of blood in potential space between dura and bone (intracranial or spinal)

A

Epidural Hematoma

35
Q

Accumulation of blood below inner dura but external to brain

A

Subdural Hematoma

36
Q

Most common type of traumatic intracranial lesion

A

Subdural Hematoma

37
Q

Often secondary to trauma or tearing of bridging veins

A

Subdural Hematoma

38
Q

Epidural and Subdural Hematoma Tx

A

Reverse coag (Vitamin K, FFP, clotting factors)

Hyperosmolar therapy if high ICP

SURGERY

39
Q

Sudden onset of “worst headache of life” with N/V, seizure, altered mental status

A

Subarachnoid Hemorrhage (ruptured saccular aneurysm)

40
Q

Prodrome of sudden head pain may precede rupture by days to months (average is 2 weeks)

A

Sentinal Leaks - SAH

41
Q

CSF in SAH

A

markedly elevated opening pressures

grossly bloody fluid

CLIN MED II, NEURO (3 decks)

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