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Flashcards in Stroke Therapy Deck (12)
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1

What is the loss of neurons, synapses and axonal fibres with every minute that a large vessel ischaemic stroke is untreated?

1.9 million neurons
13.8 billion synapses
12km axonal fibres

2

What is the aim of thrombolysis?

To restore perfusion before cell death occurs

3

What are the risk factors for haemorrhage after thrombolysis?

Age
Infarct size
Vessel occlusion
Diabetes
Hypertension
Stroke severity
Tissue changes
Antiplatelets

4

When does the benefit of alteplase outweigh the risk?

When used up to 4.5 hours after the onset of symptoms in accordance with the licence

5

What is the benefit of alteplase in stroke treatment dependent on?

Highly time-dependent
Minimising time to start of treatment is critical to ensuring the best possible outcome

6

What is the FAST treatment used for?

Stroke symptom recognition
Calling for help
Alerting hospital team
Alerting CT/radiology team
Keeping patient/relatives informed

7

What are the contraindications to thrombolysis?

Age - licence limited to < 80 y/o
Recent bleeding
Severe hypertension

8

When might heparin be used prophylactically?

In patients at moderate-high risk of DVT

9

In what patients might warfarin be used in combination with aspirin or clopidogrel?

In patients with a prosthetic heart valve

10

What is the most common serious adverse effect of warfarin?

Bleeding - benefit of anticoagulation must outweigh risk of serious bleeding

11

What are the contraindications to warfarin use?

Recent surgery
Pre-existing haemorrhagic state e.g. liver disease, renal failure, haemophilia
Pre-existing structural lesions e.g. peptic ulcers
Recent cerebral haemorrhage
Uncontrolled hypertension

12

What drugs does warfarin interact with?

Ciprofloxacin, clarithromycin, erythromycin, metronidazole, trimethoprim
Acetaminophen
Acetylsalicylic acid
NSAIDs