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cerebrovascular accidents: TIA and ischemic stroke

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Question
Answer
show hemorrhagic and ischemic  
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show transient ischemic attack and stroke  
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ischemic stroke   show
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show bleeding occurs inside or around the brain tissue  
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show artheromas in major cerebral arteries in areas of turbulent flow  
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emboli lodged in cerebral artery because of:   show
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show bleeding in space between brain and skull caused by aneurism  
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symptoms of SAH   show
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show nuchal regidity, paralysis  
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Tx goal of SAH   show
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Tx choice for SAH   show
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show phenytoin  
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Tx of rebleeding   show
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Tx of hydrocephalus   show
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show age (risk doubled every decade after 55) gender M>F low birth weight race black>hispanic>white genetics - paternal history  
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show HTN, smoking, alcohol, diabetes, A fib, dyslipidemia, CHD, sickle cell, post menopausal therapy, obesity, diet, body fat distribution, physical inactivity  
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show treat modifiable risk factors aspirin use recomended in women >65y/o with high stroke risk  
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assessment of TIA and ischemic stroke   show
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show identifies location of ischemia guides theraputic decisions  
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NIHSS score <20   show
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NIHSS score >22   show
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transient ischemic attack (TIA)   show
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show rapid symptom onset Sx resolves w/i 24h usually in 15mins no residual neurologic deficit warning sign of impending stroke  
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show permanent focal neurologic lesion (cell death has occured)  
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course of stroke   show
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symptoms of TIA and stroke   show
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F.A.S.T.   show
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acute Tx of TIA   show
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TIA goals for therapy   show
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show ASA 325mg po qd (immediately) (clopidigrel 75mg po qd if allergic to ASA)  
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benefits of ASA   show
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show Alteplase (tPA) MUST ADMINISTER WITHIN 3 HOURS OF SYMPTOM ONSET (based on efficacy and safety)  
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show infuse 0.9mg/kg IV over 60 minutes within 10% of the dose given as a bolus over 1 minute (max bolus dose 90mg)  
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show prevent complications reduce long standing neurological deficits physical therapy/occupational therapy  
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additional Tx for ischemic stroke   show
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acute ischemic stroke BP drugs   show
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antithrombotic therapy in acute ischemic stroke   show
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secondary stroke prevention general principles   show
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show ASA 50-325mg monotherapy OR dipyridamole 200mg ER + ASA 25mg (aggrenox) BID OR clopidigrel 75mg po qd monotherapy  
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show aggrenox or plavix monotherapies are more recommended than ASA alone  
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show clopidigrel more prefered by neurologists due to less adverse reactions  
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show HA, GI, dizziness, fainting, more bleeding  
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ASA + clopidigrel   show
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ASA + aggrenox   show
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show use them they are good for you decrease risk of stroke by 18% with or without CHD  
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Created by: lex86
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