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
WEEK 19:
Stroke:
| Question | Answer |
|---|---|
| stroke definition | sudden loss of blood circulation to an area of brain resulting in a corresponding loss of neurological function |
| incidence of stroke | increasing incidence with age with a peak incidence 80-84 years of age and is more common in men than women |
| stroke facts(leading cause of what) | leading cause of disability in UK where almost 2/3 of stroke survivors leave hospital with a disability |
| types of stroke | ischaemic (85%) and haemorrhagic |
| ischaemic stroke | decreased arterial blood flow or venous outflow from a tissue caused by platelet thrombosis that develops over a disrupted atherosclerotic plaque commonly involved in arteries/ embolism from other source |
| stroke develops in | periphery of cortex |
| pale infarct | when reperfusion often does not occur so area of infarct remains pale |
| what happens to the brain when stroke occurs | swelling (hallmark of cellular damage) leading to loss of demarcation between grey and white matter and break down of myelin |
| gliosis | reaction to injury where astrocytes proliferate at margins of infarct and microglial cells (macrophages) remove lipid debris |
| when do cystic areas develop | after 10 days - 3 weeks due to liquifactive necrosis |
| most thromboembolic strokes are associated with | atherosclerosis and have the same risk factors as other atherosclerotic conditions (eg angina and MI) |
| Virchows triad | stasis, vessel wall injury, and hypercoagulation |
| some risk factors for stroke | high blood pressure, high cholesterol, type 2 diabetes, smoking, drug, no physical exercise etc |
| embolism can originate from where | from a DVT in patients with patent foramen ovale |
| why is AF a progenitor of embolic strokes | due to thrombus formation in the LA from statis of blood |
| lacunar infarcts | small ischaemic strokes to deep white matter of brain which are less than 1cm in diameter and secondary to hypertension of diabetes mellitus |
| hamorrhagic stroke is most often caused by | stress placed on vessels by hypertension where intracerebral haematoma pushes brain tissue aside |
| symptoms of stroke | movement and sensation (eg sensory loss in limbs), speech (expressive aphasia), vision (visual field defects), and personality (front lobe affected) |
| what should you do with a patient with acute onset of a neurological syndrome with persisting symptoms and signs (stroke) | need urgent diagnostic assessment to differentiate between acute stroke and other causes |
| what is the best diagnostic test for stroke | CT scan without contrast (distinguish haemorrhage from non haemorrhage) then MRI |
| what treatment is contraindicated in haemorrhagic stroke and why | thrombolytics as they break down clots which would increase bleeding in brain |
| stroke treatment acutely | general BM, O2 stats, temp, BP lowered in acute phase, statin started after 48 hours |
| when should statin be started | after 48 hours |
| once haemorrhage excluded what is given | 30mg aspirin stat |
| transient ischaemic attack (TIAS) | transient episode of neurological dysfunction caused by focal brain/ spinal cord or retinal ischaemia without infarction or symptoms lasting less than 24 hours |
| treatment of TIA | antiplatelet therapy as soon as intracranial haemorrhage ruled out eg clopidogrel and aspirin, lifestyle advice etc |
| chronic treatment in stroke | antiplatelet treatment (aspirin, clopidogrel), warfarin for embolic type strokes caused by AF, and treating factors for stroke eg hypertension or diabetes |
| best antiplatelet treatment | long term clopidogrel (or aspirin and dipyridamole is cannot tolerate clopidogrel) |
| examples of antiplatelet treatment | aspirin and clopidogrel |
Created by:
kablooey
Popular Medical sets