OMS - 2 Neuro Final > Stroke > Flashcards

Stroke Flashcards

(69 cards)

Study These Flashcards
1
Q

Define stroke

A

Acute focal injury are the central nervous system by vascular cause → deficit

(irreversible brain damage, brain cell death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Two main different types of stroke

A
  • Ischemic ~80% (TOAST)
  • Hemorrhagic ~20% (SAH & ICH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

New criteria for dx stroke

A

TOAST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

stroke is the _______ MC cause of death in the US

A

3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of ischemic Strokes

A
  • Large artery
  • Lacunar
  • Cryptogenic (unknown origin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Difference between a ischemic stroke and “mini stroke”

A
  • TIA = “mini stroke”: FND (focal neurologic deficit) resolves in minutes, imaging normal
  • Ischemic stroke: permanent, irreversible FND
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Modifiable risk factors for stroke (5)

A
  1. HTN
  2. Hyperlipidemia
  3. DM
  4. Heart: CAD, A-fib
  5. Diet/lifestyle: Tobacco
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stroke: non-modifiable risk factors (4)

A
  1. Age (increases every year, 60+)
  2. Sex (young male & 65+ females MC)
  3. Genetics
  4. Fam Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is included in the ABCD2 score?

A
  • Age
  • BP >140/90
  • Clinical feature: weakness 2 points, speech=1
  • Duration
  • Diabetes 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 Types of TIA

A
  1. Embolic
  2. Lacunar
  3. Large artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

2 Types of hemorrhagic stroke

A
  1. Intraparenchymal
  2. Subarachnoid hemorrhage

(star of death: aneurysm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Watershed stroke looks like ______ on imaging

A

linear pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 Causes of ischemic stroke

A
  1. cardio (clots from heart or emobli from sepsis)
  2. atherosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an important reference for determining where the acute ischemic stroke is in the brain?

A

Motor homunculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ACA territory stroke: symptoms (5)

A
  1. Contralateral leg weakness
  2. Urinary incontinence
  3. Akinetic Mutism
  4. Tactile agnosia
  5. Gait impairment

(supplies frontal lobe & parietal lobe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MC LVO’s

A

MCA territory stroke

(usually dominant (left) hemisphere)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PCA territory stroke: presentation

A
  • Contralateral homonymous hemianopia
  • Hemisensory loss

(occipital lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MCA territory stroke: symptoms

A
  1. Contralateral hemiparesis
  2. Contralateral hemisensory loss
  3. Hemianopia
  4. Aphasia: depends on location/size
  5. Hemispatial neglect (cannot preceive one half of the world around them)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thalamic stroke (aka Lacunar Strokes (means “little lake”)) is a _____ etiology.

A

hypertensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pure motor stroke (lacunar stroke syndrome): deficit

A

Contralateral hemiparesis: weak face, arm, leg

(pure sensory is numb face, arm, leg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thalamic stroke sensory deficits (aka Pure sensory stroke or lacunar stroke syndrome) & nuclei involved.

A
  1. VPL of thalamus (L for Limb)
  2. VPM nucleas for face (M for mask, meaning face)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pure sensory stroke (lacunar stroke syndrome): presentation

A

Contralateral hemisensory loss: numb face, arm, leg

(pure motor is contralateral hemiparesis: weak face, arm, leg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Thalamocapsular stroke (aka sensorimotor stroke or lacunar stroke syndrome) is combined ____ deficits. Damage to the ____ (2).

A
  • Contralateral paresis and sensory loss
  • Internal capsule + thalamus

(mix between pure motor & pure sensory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dysarthria-Clumsy Hand (lacunar stroke syndrome): presentation (2)

A
  1. Slurred speech
  2. Weakness of contralateral hand; decreased fine motor skills
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Dysarthria-Clumsy Hand (lacunar stroke syndrome): damage to \_\_\_\_\_
pons (CN V-VII) (it can localize anywhere outside the CNS)
26
Ataxia-Hemiparesis (lacunar stroke syndrome): presentation
1. Weak leg 2. incoordination of ipsilateral arm & leg (Contralateral hemiparesis and ataxia)
27
CADASIL is due to a ______ mutation
notch 3 | (AD)
28
Fabry's Disease genetic inheritance
X-linked
29
Fabry's disease causes stroke and is due to \_\_\_\_\_\_\_.
lysosomal alpha-galactosidase A deficiency
30
CADASIL patients have recurrent \_\_\_\_\_\_
small vessel strokes
31
Initial evaluation: Stroke code
1. Straight to the scanner! ("time is brain"~ 2 million neurons die/min) 2. CT head 3. MRI 4. CBC, PT/INR, CMP, glucose 5. TTE (don't need contrast for CT or MRI, only w/angio)
32
What is one of the most important questions when working up a patient with a possible stroke?
"When was the patient last known well?" (we need to know when the symptoms started)
33
What is evaluated in an NIHSS score?
34
Define ischemic penumbra
Potential irreversible brain tissue injury caused by hypoperfusion after a stroke (can be calculated and mapped)
35
What is this (image to the right)?
* this identifies the ischemic penumbra * green = penumbra * red = ischemic core
36
Acute stroke therapy: 2 options
1. Thrombolysis: TPA, tenecteplase 2. Endovascular
37
Thrombolysis (TPA): inclusion criteria (2)
NIH\>2 or ***_disabling_*** sx
38
tPA relative contraindications
glucose \< 40 (make sure the sx aren't due to hypoglycemia)
39
Thrombolysis: exclusion criteria (5)
1. Intracranial ***_hemorrhage_*** (last 3 mo.) 2. Hypertensive (SBP must be \<185/110) 3. Active internal bleeding 4. Bleeding at non-compressible site 5. symptoms for \>4.5 hrs
40
Endovascular therapy (mechanical thrombectomy) indications (2)
1. Can be performed up to 24 hours after onset of symptoms 2. NIH \> 5
41
Endovascular (mechanical thrombectomy): inclusion criteria
* Evidence of large vessel occlusion on CT angio / perfusion * Sizable ischemic penumbra relative to ischemic core
42
Post-acute stroke therapy management (after thrombectomy) (2)
1. CTP 2. CTA
43
Post-acute stroke therapy management (after tPA) (4)
1. Close neurologic monitoring in ICU for 24 hours 2. BP control between 160-185 mmHg 3. no anti-platelet or anti-coagulation for 24 hours 4. repeat CT
44
Post-acute stroke therapy: blood pressure must be \_\_\_\_\_\_\_\_.
between 140-185 (can reduce by 20 mmHg over the next 24 hours)
45
Define young stroke
Strokes in patients less than 50 years old
46
Workup for patients who present with a stroke who are less than 50 years old (3).
1. Hypercoagulable panel 2. Transesophageal echocardiogram (Patent foramen ovale) 3. Long-term cardiac monitoring (A fib)
47
Hypercoagulable panel includes (5)
1. factor deficiency 2. protein deficiency 3. mutations 4. antiphospholipid Ab syndrome 5. lipoprotein
48
Gold standard for ischemic stroke evaluation
MRI (more detail of brain tissue, stroke territory, edema)
49
Left: Right:
* Diffusion-weighted: white = ischemia * Paired diffusion co-efficient map: black = ischemia (confirms stroke: if white on diffusion-weighted and dark or "drop out" on co-efficient map)
50
Acute stroke management after TPA or thrombectomy (3)
1. PT/TOT 2. speech therapy 3. screen for depression
51
Stroke complications (3)
1. cerebral edema 2. epilepsy 3. depression
52
Stroke: prevention recommendations
1. Diet (Mediterranean diet: fruit, veggie, lean meat, nuts) 2. Exercise: 150 min moderate/week or 30 min x 5 days 3. Blood pressure control 4. Blood glucose control 5. Weight control
53
hyperhomocysteinuria can cause stroke and is due to \_\_\_\_\_\_\_.
impaired cystathionine B-synthase | (AR)
54
Fibromuscular dysplasia can have a stroke due to \_\_\_\_\_\_\_.
arterial dissection
55
polycystic kidney disease is associated with ______ & \_\_\_\_\_.
* berry aneurysms * SAH
56
Marfan's orr Ehlers-Danlos type IV is associated with stroke due to \_\_\_\_\_.
dissection
57
MELAS can cause stroke and is due to \_\_\_\_\_\_\_\_.
mitochondrial disease w/metaboic stroke-like brain lesions
58
FAST
* Face : can they smile * Arms : can they raise arms * Speech * Time
59
Right-hemisphere stroke deficits (2)
1. left side movement & sensation 2. analytical & perception tasks
60
Left-hemisphere stroke deficits (2)
1. right-sided movement/sensation 2. speech/language ability
61
Gaze preference
they look toward the side of the stroke
62
cerebellar stroke patients will present with \_\_\_\_\_\_.
balance & coordination deficits
63
Brain stem strokes will present with ______ (4) deficits.
1. eye movement 2. hearing 3. speech 4. swallowing
64
Dominant hemisphere stroke sx (2)
1. aphasia 2. contralateral hemiplegia: arm/face\>leg
65
Non-dominant hemisphere stroke sx (2)
1. contralateral hemi-neglect 2. contralateral hemiplegia arm/face\>leg
66
Parietal-occiptal stroke deficit (3)
1. visual 2. sensory 3. language
67
Stroke/lesion location: facial numbness, weak jaw, lateral rectus palsy, facial weakness
* CN V – facial numbness, weak jaw movement * CN VI – lateral rectus palsy * CN VII – facial weakness
68
Stroke/lesion location: vertigo/hearing loss, dysphagia, weak palate or tongue weakness
* CN VIII – vertigo, hearing loss * CN IX, X – dysphagia, weak palate * CN XII – tongue weakness
69
metabolic workup for stroke patient (5)
1. lipid panel 2. HbA1C 3. TSH 4. Blood glucose 5. T/PTT/INR
OMS - 2 Neuro Final
flashcards
Decks in class (36)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions