Stroke - ischaemic 3

Question 1

What are the 2 main types of anti-platelets used ?

Answer 1

Asprin and Clopidogrel or ticagrelor

Question 2

What are the 3 main types of anti-coagulants used ?

Answer 2

Heparin and wafarin (avoid all these in haemorrhagic type strokes)

Question 3

What secondary prevention measure can be considered for patients shown to have significant carotid artery stenosis ? (usually > or equal to 70%)

Answer 3

Carotid endarterectomy

Question 4

What scoring system is used to estimate the risk of stroke in AF and ==> determine whether or not to start anti-coagulant/anti-platelet treatment ?

Answer 4

CHA₂DS₂VASc score

bascially having had a stroke they are immediately high risk and ==? get put on anticoagulation

Anti-coagulation more effective for

Question 5

What is the purpose of the HAS-BLED score?

Answer 5

Used to assess 1-year risk of major bleeding in patients with AFa score of ≥3 indicates “high risk” and some caution and regular review of the patient is needed

Question 6

What are the specific dietary recommendations for secondary prevention of stroke ?

Answer 6

Cardioprotective diet:

A to eat an optimum diet that includes:

• five or more portions of fruit and vegetables per day from a variety of sources;
• two portions of oily fish per week (salmon, trout, herring, pilchards, sardines, fresh tuna).

B to reduce and replace saturated fats in their diet with polyunsaturated or monounsaturated fats

C - to reduce their salt intake

Question 7

What treatment alongside medications (this isnt provided by doctors really) will be required for strokes (think about mum)?

Answer 7

Rehbailitation - from specialist physio

Question 8

What are the signs/symptoms of TIA?

Answer 8

• Mimic those of strokes
• Note emboli may also pass to the retinal artery causing amaurosis fugax (one eyes vision is progressively lost ‘‘like a curtain descending over my field of view’’

Question 9

What assessment should be done to measure someones risk of subsequent stroke following TIA?

Answer 9

ABCD2 assessment

Question 10

What is the treatment options for TIA’s?

Answer 10

• Same investigations done as for strokes, this allows differentiation between likely cardioembolic or atheroembolic
• Follow the same secondary prevention measures as in stroke
• Carotid endartectomy if > or equal to 70% carotid stenosis done

Question 11

How long should driving be avoided following a TIA?

Answer 11

For 1 month and only need to inform DVLA if had multiple attacks in short period of time

Question 12

What type of stroke is shown

Answer 12

Ischaemic stroke

Question 13

What type of stroke is shown ?

Answer 13

Haemorrhage stroke