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Patho Pharm 3 > TIA and Stroke > Flashcards

TIA and Stroke Flashcards

1
Q

What is a Transient Ischemic Attack?

A

An acute, focal cerebral insufficiency that lasts less than 24 hours but it usually less than 60 minutes and leaves no residual effects. It is a brief episode of neurological dysfunction resulting from an interruption in the blood supply to the brain or the eye, sometimes as a precursor of a stroke.

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2
Q

When is stroke risk the highest following a Transient Ischemic Attack

A

1st month

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3
Q

What does someone with a TIA look like?

A

1-sided facial droop that is forehead-sparing

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4
Q

What does a carotid TIA/stroke look like?

A

weak and heavy contralateral arm + leg and face, numbness, dysphagia, ipsilateral one-eye visual loss

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5
Q

What does a vertebrobasilar TIA/stroke look like?

A

dim/blurry vision, vertigo, dysphagia, ataxia on the body contralaterally and on the face ipsilaterally

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6
Q

How is a TIA/stroke diagnosed?

A

history and physical, CT, MRI, MRA, carotid doppler, or an ECHOcardiogram

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7
Q

How is a TIA/stroke treated?

A

anticoagulants (ASA), anti-platelets (clopidogrel), carotid endarterectomy with > 70% stenosis

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8
Q

What are the leading risk factors for a stroke

A

Hypertension (Hemorrhagic), Hyperlipidemia (Ischemic), and tobacco use

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9
Q

What are the secondary risk factors for a stroke?

A

African American, Age, men, Atrial Fibrillation

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10
Q

What are the less likely risk factors for a stroke?

A

DM, obesity, alcohol, family history, birth control, sickle cell anemia, physical inactivity, arterial diseases, TIA history, Cocaine, Heart Failure

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11
Q

What is an Ischemic Stroke?

A

occlusion of a cerebral artery by a thrombus or ane embolus that causes O2 deprivation, irreversible damage, and neuro deficits

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12
Q

What is a Thrombotic Stroke (ischemic)?

A

A thrombus forms due to atherosclerosis in a vessel or a hypercoagulable state (Birth Control). This is usually seen in older individuals with high cholesterol, atherosclerosis, or DM

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13
Q

What is an Embolic stroke (Ischemic)?

A

Occurs when a clot or debris (embolus) travels from one part of the body and lodges in a narrower brain artery, blocking blood flow to the brain.

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14
Q

What would cause an embolic stroke?

A

thrombus, valve vegetation, a venous clot in atrial septal defect or PFO, carotid plaque, A.Fib, mitral valve vegetation

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15
Q

What is a Penumbra?

A

the area surrounding an ischemic event such as a thrombotic or embolic stroke. This ischemic area is viable for 3 hours

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16
Q

What is a Hemorrhagic Stroke?

A

bleeding within the brain parenchyma (tissue) that is associated with long-standing, severe, untreated Hypertension

17
Q

What comes as a direct result of a hemorrhagic stroke?

A

increased intracranial pressure, herniation, death

18
Q

What are the two types of intracranial hemorrhages?

A

epidural and subdural

19
Q

Where does an epidural intracranial hemorrhage take place?

A

between the skull and the dura mater

20
Q

Where does a subdural intracranial hemorrhage take place?

A

between the dura mater and the arachnoid matter

21
Q

How does an epidural intracranial hemorrhage occur?

A

skull fractures tear an underlying blood vessel (arteries)

22
Q

Is a subdural or epidural intracranial hemorrhage worse?

A

subdural

23
Q

How does an subdural intracranial hemorrhage occur?

A

a type of bleeding that occurs outside the brain as a result of a severe head injury. It takes place when blood vessels burst between the brain and the leather-like membrane that wraps around the brain (the dura mater). the brain moves within the skull but the vessels don’t (bridging veins)

24
Q

How fast does decline occur with a subdural hemorrhage?

A

can be very rapid or very slow (2-10 days)

25
Q

Where does a Subarachnoid hemorrhage take place?

A

between the outer arachnoid and pia mater

26
Q

How does a subarachnoid hemorrhage occur?

A

rupture of a cerebral Berry aneurysm or arterio-venous malformation that usually occurs in 30-60-year-olds

27
Q

What is a hallmark sign of a subarachnoid hemorrhage?

A

blood in the Cerebrospinal fluid (CSF)

28
Q

How fast must you treat a stroke?

A

3 hours

29
Q

How would someone present with a hemorrhagic stroke?

A

rapid level of consciousness change, meninges irritation in the form of nuchal rigidity, photophobia

30
Q

What does it mean if someone claims they have “the worst headache of my life”?

A

HEMORRHAGIC STROKE!

31
Q

How long is there a re-bleeding risk?

A

first 24 hours

32
Q

Will an MRI detect an intracranial hemorrhage?

A

NO

33
Q

what does “BE FAST” stand for?

A

Balance loss
Eyes
Face uneven
Arm weakness
Speech
Time to call 911

34
Q

What can you do to treat a patient with a possible stroke?

A

ABC’s, CT scan W/o contrast, penumbra procedure to try and save the area

35
Q

What are the left-brain consequences of a stroke?

A

loss of logic, verbal, details, science, names, math, thinking, writing, slow/cautious behavior, memory loss, organizational impairment

36
Q

What are the right-brain consequences of a stroke?

A

loss of pictures, stories, music, patterns, big picture, imagination, denies problems, impaired judgment, impulsivity, safety problems, short attention span

37
Q

What are the consequences of a stroke?

A

aspiration risk, motor and sensory deficits, flaccidity on the contralateral side, spasticity in 6 weeks, contralateral field blindness, homonymous hemianopsia (vision), dysphasia, aphasia, dysarthria, expressive and receptive aphasia, depression, memory problems

38
Q

What are some Altered personality effects of a stroke?

A

increased emotional responses, slow reactions, hesitant, cautious, confused, disoriented

Patho Pharm 3 (10 decks)

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