Stroke and TIA Flashcards

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1
Q

When we think about strokes which mnemonic comes to mind

A

FAST

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2
Q

What does the mnemonic FAST stand for

A

Face
Arms
Speech
Time

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3
Q

What dow e need to consider if a patient has had a stroke

A
  1. Patients may need a bit more help if disability profound
  2. Drugs used after having a stroke can affect oral mucosa
  3. Issue of capacity and informed consent is crucial
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4
Q

What is a stroke

A

A sudden onset of facial neurological symptoms of a presumed vascular aetiology lasting more than 24 hours

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5
Q

What is a TIA

A

They are by definition transient and an ischaemic attack

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6
Q

Which organ get damaged following TIA or Stroke

A

Death of Brian tissue results

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7
Q

What are most strokes caused by

A

80% ischaemic in origin

20% Haemorrhagic in origin

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8
Q

Why do ischaemic strokes happen

A

Due to underlying cardiovascular disease

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9
Q

What categories do risk factors fall into

A
  1. Modifiable

2. Non modifiable

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10
Q

List some non modifiable risk factors for stroke

A
  1. Age
  2. Ethnicity
  3. Gender
  4. Family history of heart disease
  5. History of heart disease
  6. PFO (hole in heart)
  7. Type 1 diabetes
  8. Atrial fibrillation
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11
Q

List some modifiable risk factors for stroke

A
  1. High blood pressure e
  2. High blood cholesterol
  3. Type 2 diabetes
  4. Being overweight
  5. Alcohol consumption
  6. Smoking
  7. Drug use
  8. Sedentary lifestyle
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12
Q

Give some long term clinical features of a stroke

A
  1. Limb weakness
  2. Facial paralysis
  3. Speech disturbances
  4. Visual defects
  5. Bowel and bladder dysfunction
  6. Neuropathic pain
  7. Swallowing difficulties
  8. Cognitive difficulties
  9. Communication difficulties
  10. Inability to write
  11. Mobility issues
  12. Inability to maintain self-care
  13. Mood disturbances
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13
Q

Talk through the treatment of the acute phase of a stroke

A
  1. Medical emergency where time is crustal
  2. Thrombolysis to bust clots
  3. Supportive care
  4. Thrombectomy, craniotomy, shunt placement
  5. Rehabilitation
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14
Q

What os the post treatment plan of a stroke dependant on

A

If it was of:

  1. Ischaemic aetiology
  2. Heamorrhagic aetiology
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15
Q

Talk though the post treatment of a stroke of ischaemic aetiology

A
  1. Lifestyle modifications
  2. Anti-platelet drugs
  3. Anticoagulants
  4. Carotid enderterctomy
  5. Rehab, continence care, nursing home support,
  6. Psychological support
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16
Q

Give examples of Anti-platelet drugs

A

Aspirin

Clopidogrel

17
Q

Give examples of Anticoagulants

A

Warfarin

Novel or direct oral Anticoagulants (NOACS/ DOACs)

18
Q

Talk though the post treatment of a stroke of haemorrhagic aetiology

A

Largely supportive focuses on BP management and stopping pro- haemorrhage medications

19
Q

is even stroke patient mentally compromised

A

no we need to consider every patient individually

20
Q

How can communication be challenging following a stroke

A
  1. Patient may not understand you
  2. Ability to talk to you may be compromised
  3. You may need to find some alternative material stop help the patient understand and consent
21
Q

What things should we consider when treating a patient who has had a stroke

A
  1. Emergency management of the acute stroke
  2. Physical access tot eh dental surgery
  3. Capacity assessment
  4. Adaptations to the toothbrush
  5. Difficulties with denture
  6. Drooling
  7. Poor OH
  8. Anticoagulants and other drugs may modify your treatment plan