Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CM Stroke Mngment
Stroke Management
| Question | Answer |
|---|---|
| Stroke Risk Factors | older age (every decade over age 55, risk doubles), men (more women die from stroke), AA, hispanic, obesity, alcohol abuse, smoking, poor diet/nutrition |
| Modifiable risk factors | HTN, atrial fib, carotid stenosis, diabetes, hyperlipidemia, prior stroke, TIA |
| How much can weight reduction lower bp? | up to 20mmHG/10kg weight loss |
| Single most treatale risk factor for stroke | High bp |
| What percentage Risk Reduction is acheivable with aspirin? | 22% |
| Warfarin vs Aspirin | Warfarin has better risk reduction (45%). |
| CHADS pneumonic | CHF, HTN, Age >75, Diabetes, Stroke of TIA. (6 possible points. 3 is high treat with warfarin. Moderate =2 points, can argue either way with warfarin. Below 2, treat with aspirin) |
| If CHADs score is 2 from previous stroke, tx with | Warfarin. |
| % stenosis = 1- (A/B), what is A? | A is the area of tightest narrowing. B is the normal width |
| What is the impact of tight glucose control on macrovascular complications? | none. Macrovascular complications not affected by glucose control. Tight control of HTN is the goal. |
| Cholesterol and RR | No evidence that lowering cholesterol overall affects stroke incidence. But if you use statins in patients with CHD, there is a risk reduction |
| Aspirin in low-risk pts | no data to support using Aspirin. Risk outweighs benefit (bleeds). Aspirin recommended for 10-yr cardiovascular risk 6-10% |
| Only FDA approved therapy for pts with acute stroke | IV-tPA (clot busting drug) |
| What is the protocol for giving tPA | initiated within 3 hours of sx onset (taken from the last time the pt was known to be sx free). Head CT without evidence of hemorrhage or other complicating lesion |
| What are pts treated with if they are not candidates for receiving tPA? | endovascular - catheter, remove clot mechanically |
| MERCI clot retriever | Used to remove clots |
| Acute stroke management | Temperature, Fluids/Glucose, BP, Antithrombotic agents |
| Cerebral Blood flow equation | MAP/CVR; if you stand, MAP decreases, so CVR accomodates this by decreasing/dilating in order to keep CBF constant. |
| In stroke patients, CVR is | constant. If MAP is decreased, then CBF decreases; there is some data to suggest that tx of antihypertensives in acute pts can be harmful. So don't treat high bp acutely |
| Only data available on anticoagulation in acute pts is on which drug | Aspirin (when started within 48 hours) decreases recurrent events up front. Need to treat 100 pts to decrease 1 stroke |
| 3 top complications in stroke patients | UTI (11%), CHF (10% - watch fluids!), Pneumonia (10%) |
| DVT prophylaxis | given to all stroke patients who can't get up and walk. DVT risk is 2% |
| Secondary Prevention | Platelet antiaggregants, anticoagulants, blood pressure, lipid lowering, endarterectomy |
| Prior stroke patients treated with Warfarin have what type of Risk Reduction? | 67% decrease in risk when treated with Warfarin |
| Each 10mmHg decrease in systolic BP is associated with _____% decrease in stroke risk? | 28%. Do not use acutely |
| Motor recovery after stroke is determined by | the severity of the stroke |
Created by:
ltm12