Identity Crisis
Toprol XL
What are 4 easily identifiable signs of stroke?
Face, arms, speech, time
Which Categories in CHADSVASC receive 2 points?
Age over 75
prior stroke, TIA or thromboembolism
Is rate control or rhythm control preferred in permanent Atrial Fibrillation?
Rate
When is apixaban dose adjusted to 2.5mg by mouth twice a day
CrCl <30
2 of 3 (over 80, less than 60kg, Scr>1.5).
Xarelto
rivoaroxaban
What type of event is defined as a brief neurologic dysfunction without evidence of infarction that typically lasts less than 1 hour
Transient Ischemic Attack
At what CHADSVASc score is anticoagulation therapy suggested?
1 in a male or 2 in a female
What are the 2 heart rate goals in atrial fibrillation and who receives them?
80bpm: symptomatic, 110: asymptomatic
What is recommended for anti-coagulation for patients with Atrial Fibrillation and a qualifying CHA2DS2VASc score?
Non-vitamin K antagonist
dabigatran
Pradaxa
What 2 things must be checked before administration of Alteplase?
Blood Glucose (Needs to be over 50mg/dL), Blood Pressure (Needs to be less than 185/110mmHg)
Name all components in CHADSVASC
CHF, Hypertension Age >75, DM, Stroke/TIA/Thromboembolism, Vascular Disease, Age 64-75, female
Name one BBW of amiodarone
Pulmonary toxicity, exacerbation of arrhythmia, hepatotoxicity
What is the INR goal for patients on warfarin for Atrial Fibrillation?
If patients are not at goal X% of the time, they should be considered for a DOAC.
2-3
70% of the time
Aggrenox
Aspirin + dipyridamole
Name 5 contraindications of receiving alteplase within 3 hours of last known normal
INR of over 1.7, STEMI in last 3 months, BP>185/110mmHg, LMWH in last 24 hours, under 18, BG <50, unknown last known normal, Ischemic stroke in last 3 months, Head trauma in last 3 months, spinal injury in last 3 months, subarachnoid hemorrhage, platelets less than 100,000, aPTT>40 seconds, PT> 15 seconds, DOAC in last 48 hours
Name 3 risk factors for Atrial Fibrillation
Increased age, hypertension, DM, MI, Vascular heart disease, HF, obesity, OSA, Smoking, Cadiothoracic surgery, alcohol use, hyperthyroidism, genetics, heart
Name the 2 drugs that can be used for the “pill in pocket” method of rhythm control
Propafenone, flecainide
Which DOAC should be taken with food?
Xarelto
Betapace
Name 2 High intensity statins with dose
Atorvastatin 80mg
Rosuvastatin 20mg
At what HASBLED score do you not anti-coagulate?
Always anti-coagulate, determine ways to lower HASBLED Score to below 3
Name 2 requirements of using the “pill in pocket” method of rhythm control
Trialed under medical supervision
On an AV nodal blocking agent (non-DHP CCB or BB)
How long should dual anti-platelet therapy be continued after a stroke?
21 Days