Stroke MC

Question 1

what are the modifiable risk factors of stroke?

Answer 1

hypertension
AF
diabetes
hyperlipidaemia
smoking

Question 2

what are the non-modifable risk factors of a stroke?

Answer 2

age
gender
family history
afro-caribbean ethinicty

Question 3

what can you give to reduce the risk of hypertension?

Answer 3

Antihypertensives
< 55years old ACE Inhibitors
> 55 years old Calcium Channel blockers

Question 4

what is the taregt blood pressure with antihypertensives?

Answer 4

Target blood pressurw 140/90 mmHg for <80 years old and 150/90mmgHg for >80 years old
Other targets for diabetic patients

Question 5

what is the treatment to reduce AF risk?

Answer 5

Anticoagulation – used to prevent a clot forming and breaking of to produce a stroke.
Warfarin
Rate control – control heart rate. First line is standard dose Beta Blocker (bisoprolol) .
*if the BNF doesn’t list it but it is on NICE guidelines this is fine as they don’t always need to have a manufacturing test

Question 6

what is the treatment to reduce risk of diabetes?

Answer 6

Metformin and move through first and second treatments.

Type 1 – basal bolus insulin QDS

Question 7

what do we need to get the HbA1C?

Answer 7

Need to make sure the CVD risk is minimised and microvascular risk is minimised.
Keep an eye on eyes and feet.
HbA1C = 48, some patients who may never get to this can be moved to 58

Question 8

what do you use to redcue the rsik of hyperlipidaemia?

Answer 8

Statins

- Atorvastatin 1st line high intensity with a long half life so can be given at any time of the day.

Question 9

what happens if a patient has a high HAS-BLED?

Answer 9

Anticoagulation can be either warfarin or a DOAC.