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Systemic Disease in Dentistry > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a cardioembolic stroke?

A

An embolism which travels from the heart to block a blood vessel higher up

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2
Q

What is the biggest risk factor for stroke?

A

Transient Ischaemic Attack (TIA)

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3
Q

Name 5 risk factors for stroke, excluding TIA

A
  1. Hypertension
  2. Smoking
  3. Diabetes
  4. Obesity
  5. Lifestyle (diet, alcohol and drug use)
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4
Q

Name 4 uncontrollable risk factors for stroke

A
  1. Family history
  2. Increased age
  3. Being male
  4. African / Asian / Hispanic background
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5
Q

Name 2 types of stroke

A
  1. Atherosclerosis

2. Embolism

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6
Q

What does ICH stand for?

A

Intra-cerebral haemorrhage

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7
Q

Name 5 risk factors for ICH

A
  1. Prolonged HTN
  2. Amyloid Angiopathy
  3. Age
  4. Head trauma
  5. Structural abnormalities e.g Cavernoma
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8
Q

Describe how antithrombotic drugs may be viewed ask a risk factor with regards to ICH

A

These drugs will not typically cause a bleed but will make a bleed much worse when it occurs

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9
Q

Describe the slogan used for how to act if a person is having a suspected stroke

A

F - Face drooping on one side
A - Arms unable to raise on one side
S - Speech is slurred
T - Time to call 999

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10
Q

Describe 2 important questions when determining if a person is having a stroke

A

Does it look like a stroke?

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10
Q

Describe 2 important questions when determining if a person is having a stroke

A

Does it look like a stroke?
Onset and course
General and focal symptoms (negative symptoms)

Is the patient at risk of a stroke?

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11
Q

Name 5 conditions which may mimic a stroke

A
  1. Migraine
  2. Epilepsy
  3. Structural brain lesions (tumour, abscess etc)
  4. Psychological disorders
  5. Demyelination
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12
Q

Name 5 reasons an urgent CT is needed in case of suspected stroke

A
  1. Depressed levels of concoction
  2. Papilloedema, neck stiffness or fever
  3. Severe headache at onset
  4. Thrombolysis being considered
  5. Unexplained progressive symptoms
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13
Q

Describe the relationship of blood flow and neuronal function from the core area

A
  • At core there is irreversible damage occuring which expends out to the surrounding tissue
  • In the part around the core there is reversible damage occuring but will turn to irreversible if left for too long
  • Rate at which brain damage occurs varies from person to person
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14
Q

What is the ischaemic penumbra?

A

Area of the brain where blood supply has decreased but the part of the brain has not yet died

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15
Q

What is thrombectomy>

A

Fine wire put into the brain and the clot is physically removed using stent remover

16
Q

What is the most common treatment for a stroke, given no contra-indications?

A

Thrombolysis

17
Q

Name 4 types of stroke in the Oxford classification

A
  1. TACS
  2. PACS
  3. LACS
  4. POCS
18
Q

Describe collateral circulation in the brain

A
  • Carotid artery supplies anterior of the brain
  • Vertebral artery supplies posterior of the brain
  • Circle of Willis connects the two so if one becomes occluded, there is still some supply to the part it supplies
19
Q

Describe TACS

A
  • Total anterior circulation infarct
  • Higher cortical dysfunction
  • Hemiparesis
  • Homonymous hemianopia
20
Q

Describe LACS

A
  • Lacunar infarct
  • Motor or sensory stroke affecting face, arms and legs
  • Does not cause cortical dysfunction
21
Q

Describe PACS

A
  • Partial anterior circulation stroke

- Includes 1 or 2 symptoms of TACS but not all 3

22
Q

Describe POCS

A
  • Posterior circulation stroke syndrome
  • Cranial nerve palsies
  • Bilateral motor / sensory loss
  • Cerebellar dysfunction
23
Q

Describe the survival of patients suffering from LACS, TACS, PACS and POCS

A

LACS - 2% death
TACS - 39% death
PACS - 4% death
POCS - 7% death

24
Q

Describe the relationship between oral hygeine and cardiovascular disease

A
  • Poor oral hygeine is associated with higher levels of risk of cardiovascular disease
  • Periodontitis has 25% increase of CHD
25
Q

Name an example of surgery to treat CHD

A

Carotid endarterectomy

26
Q

Name 4 complications of CEA

A
  1. Death / Stroke / MI
  2. Hyperperfusion syndrome
  3. Nerve injury
  4. Parotitis
27
Q

Name 3 facial symptoms of a stroke

A
  1. Oropharyngeal anaesthesia
  2. Facial pain or tingling
  3. Flattening nasolabial fold
28
Q

Describe peri-procedural dental management of patients taking antithrombotic medications

A
  • Medications remain in the system for up to 7 days after stopping
  • Continue aspirin when undergoing dental procedures
  • Given minimal bleeding risks, undergo dental procedures should continue warfarin
29
Q

Name 4 cardiac conditions at risk of developing infective endocarditis

A
  1. Acquired valvular heart disease with stenosis
  2. Valve replacement
  3. Structural congenital heart disease
  4. Previous IE
30
Q

Describe antibiotic prophylaxis against IE for dental procedures in a person with cardiac conditions

A
  • Do not routinely offer prophylaxis (consider in higher risk patients)
  • Do not offer chlorhexidine mouthwash prophylaxis
  • Informed consent very important

Systemic Disease in Dentistry (22 decks)

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