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BDS3 Human Disease > Stroke and TIA > Flashcards

Stroke and TIA Flashcards

1
Q

Is stroke a common cause of disease in developed countries?

A

Second or third cause of death

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2
Q

Effect of disability due to stroke

A

Cost to nhs

Burden to family

Pt daily activity change - need to adapt to new pt disability

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3
Q

Stroke definition?

A

Is a sudden nest of focal neurological symptoms caused by ischamic

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4
Q

TIA?

A

Transient ischameic attack

Symptoms resolve in 24 hours

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5
Q

2 types of stroke?

A

Hemorrhagic

Ischemic

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6
Q

Hemorrhagic stroke?

A

Haemorrhage/ bleed leads to stroke

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7
Q

What part of the brain gives ipsilteral effects?

A

Cerebellum

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8
Q

Ischaemic stroke?

A

life-threatening condition that occurs when blood flow to the brain is blocked by a blood clot or plaque buildup

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9
Q

Is a stroke in th basal ganglia big or small effect?

A

Small - fibres close of ether compared to cortex

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10
Q

Symptoms and signs of stroke?

A

Motor (clumsy or weak limb)

Sensory (loss of feeling)

Speech (dysarthria/dysphasia

Neglect / visuospatial probems

Vision: loss in one eye, or hmianopia

Gaze palsy

Ataxia/vertigo/ in coordination/nystagmus

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11
Q

Are the symptoms of stroke positive or negative systems?

A

Negative symptoms

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12
Q

What side of the brain is affected when visiospatial/neglect problems occur?

A

Right sided hemisphere stroke

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13
Q

symptoms of visual loss is a sign of what stroke?

A

Posterior stroke

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14
Q

Symptoms of ataxia is a sign of what stroke?

A

Posterior stroke

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15
Q

Posterior circulation?

A

Vertebral arteries, basilar artery

  • pons, midbrain, hindbrain and cerebellum

Sometimes occipital lobe

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16
Q

Symptoms of posterior stroke?

A

Ataxia

Vertigo in coordination

Loss of consciousness

Cardiopresiratory control

Nystagmus

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17
Q

What is the only stroke to have loss of consciousness?

A

Posterior

As basilar artery gives rose to posterior berebellar artery - to both sides, both sides of brain effected - major emergency

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18
Q

What can signs and symptoms tell you bout what type of stroke it is?

A

What side of the brain

Wat blood vessel

What blood vessel

Location

Type fo stroke

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19
Q

Stroke mimics?

A

Migraine

Epilepsy

Structural brain lesions

Metabolic/toxic disorders
- hypoglycaemia, thyroid issues

Vestibular disorders

Psychological dosders

Demylenation - MS

Mononeuropathy - brain not communicating to body, not sending the right messages about being able to move

20
Q

Why do people have strokes?

A

Problems in large and small arteries

Clots that come from the heart

Rarer causes

Bleeding due to rupture of blood vessels - carotid stenosis

21
Q

Carotid stenosis?

A

Occludes blood flow

Or makes oral blood flow - not laminar and make clots - causing a stroke

Plaque rupture and plaque and clotted blood travel in blood stream to brain

Can lodge in brain and cause focal neurological deficits

22
Q

Cardioembolic stroke cause?

A

AF commonest cause

Clot to heart

23
Q

What medication are pt with AF on?

A

Anticoagulants - warfarin/ apixiba/ riveroxiban

24
Q

What is a cardioembolic stroke?

A

occurs when a blood clot or debris from the heart blocks blood flow to the brain

25
Q

Lacunar stroke?

A

Small vessel stroke

26
Q

Cause of lacunae stroke?

A

occurs when an artery to the deep part of the brain, containing structures like the thalamus or basal ganglia, is blocked. These arteries are very small and branch off directly from a larger artery, making them particularly vulnerable to blockages.

27
Q

How to diagnose a lacunae stroke?

A

CT / MRI

28
Q

Tx for lacunar stroke?

A

Intravenous thrombolysis

29
Q

Thrombolysis?

A

A procedure that breaks up blood clots using medication or a mechanical device. This is usually performed if symptoms have been present for less than 4.5 hours

30
Q

Non-modifiable risk factor for stoke?

A

Previous stroke

Old

Male

Family history

31
Q

Most important modifiable risk factor for stroke?

A

Hypertension

32
Q

Family history relating to stroke risk factor?

A

Hypertension

Diabetes

High cholesterol

33
Q

Modifiable risk factors for stroke?

A

Smoking

Diabetes

Hypertension

Alcohol

Weight

34
Q

Lipids and stroke?

A

Development of atheroma in blood vessel walls

35
Q

Why do you need to act quickly in stroke?

A

Lose neurones, synapses and axons

36
Q

FAST?

A

F : facial weakness

A : arm weakness

S : speech problems

T : time to call

37
Q

What does FAST not take into consideration?

A

Loss of vision of vertigo

38
Q

Immediate treatment for stroke?

A

Thrombolysis - if present within 4.5 hours

Thrombecomy

39
Q

Early management or stroke?

A

Concentrates on:

Swallowing
Fluids and oxygen
Early therapy involvement
Good nursing care
Aspirin

40
Q

When can you manage stroke with thrombolysis?

A

Pt present within 4.5 hours

41
Q

Thrombectomy?

A

a minimally invasive surgical procedure that removes a blood clot from a blood vessel

42
Q

When is thrombectomy used?

A

treat acute cerebral ischemic strokes, but can also be used to treat pulmonary embolism (PE) and acute myocardial infarction (MI)

43
Q

Why is it important to have TIA pt in secondary care?

A

Likelyhood of TIA within 1 month is high

44
Q

What can be done to prevent people with TIA going ont o aging a a stroke?

A

Anticoagulants - DOACs for AF

Antiplatelets - aspirin and clopidogrel

Antihypertensives - important as this is a major cause of stroke

Statins

Carotid endarterectomy

45
Q

Medication for AF in relation to stroke?

A

DOACs and warfarin

46
Q

Effect of stroke and dentistry?

A

Arm function

Swallow problems

DOACs

Polypharmacy - xerostomia

Not able to understand or comprehend - can’t prompt and do that

47
Q

Effect of poor oral care and systemic health?

A

Infection

Atheroma plaques

  • strokes
  • lung condition
  • heart disease
  • diabetes
  • cancer
  • infection of oral procedures could affect surgeries shortly after e.g. hip replacement infection
  • endocarditis
    —> may be underlying and go to brain and cause stroke

BDS3 Human Disease (33 decks)

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