Stroke and TIA

Question 1

Is stroke a common cause of disease in developed countries?

Answer 1

Second or third cause of death

Question 2

Effect of disability due to stroke

Answer 2

Cost to nhs

Burden to family

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

Question 3

Stroke definition?

Answer 3

Is a sudden nest of focal neurological symptoms caused by ischamic

Question 4

TIA?

Answer 4

Transient ischameic attack

Symptoms resolve in 24 hours

Question 5

2 types of stroke?

Answer 5

Hemorrhagic

Ischemic

Question 6

Hemorrhagic stroke?

Answer 6

Haemorrhage/ bleed leads to stroke

Question 7

What part of the brain gives ipsilteral effects?

Answer 7

Cerebellum

Question 8

Ischaemic stroke?

Answer 8

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

Question 9

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

Answer 9

Small - fibres close of ether compared to cortex

Question 10

Symptoms and signs of stroke?

Answer 10

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

Question 11

Are the symptoms of stroke positive or negative systems?

Answer 11

Negative symptoms

Question 12

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

Answer 12

Right sided hemisphere stroke

Question 13

symptoms of visual loss is a sign of what stroke?

Answer 13

Posterior stroke

Question 14

Symptoms of ataxia is a sign of what stroke?

Answer 14

Posterior stroke

Question 15

Posterior circulation?

Answer 15

Vertebral arteries, basilar artery

• pons, midbrain, hindbrain and cerebellum

Sometimes occipital lobe

Question 16

Symptoms of posterior stroke?

Answer 16

Ataxia

Vertigo in coordination

Loss of consciousness

Cardiopresiratory control

Nystagmus

Question 17

What is the only stroke to have loss of consciousness?

Answer 17

Posterior

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

Question 18

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

Answer 18

What side of the brain

Wat blood vessel

What blood vessel

Location

Type fo stroke

Question 19

Stroke mimics?

Answer 19

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

Question 20

Why do people have strokes?

Answer 20

Problems in large and small arteries

Clots that come from the heart

Rarer causes

Bleeding due to rupture of blood vessels - carotid stenosis

Question 21

Carotid stenosis?

Answer 21

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

Question 22

Cardioembolic stroke cause?

Answer 22

AF commonest cause

Clot to heart

Question 23

What medication are pt with AF on?

Answer 23

Anticoagulants - warfarin/ apixiba/ riveroxiban

Question 24

What is a cardioembolic stroke?

Answer 24

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

Question 25

Lacunar stroke?

Answer 25

Small vessel stroke

Question 26

Cause of lacunae stroke?

Answer 26

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.

Question 27

How to diagnose a lacunae stroke?

Answer 27

CT / MRI

Question 28

Tx for lacunar stroke?

Answer 28

Intravenous thrombolysis

Question 29

Thrombolysis?

Answer 29

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

Question 30

Non-modifiable risk factor for stoke?

Answer 30

Previous stroke Old Male Family history

Question 31

Most important modifiable risk factor for stroke?

Answer 31

Hypertension

Question 32

Family history relating to stroke risk factor?

Answer 32

Hypertension Diabetes High cholesterol

Question 33

Modifiable risk factors for stroke?

Answer 33

Smoking Diabetes Hypertension Alcohol Weight

Question 34

Lipids and stroke?

Answer 34

Development of atheroma in blood vessel walls

Question 35

Why do you need to act quickly in stroke?

Answer 35

Lose neurones, synapses and axons

Question 36

FAST?

Answer 36

F : facial weakness A : arm weakness S : speech problems T : time to call

Question 37

What does FAST not take into consideration?

Answer 37

Loss of vision of vertigo

Question 38

Immediate treatment for stroke?

Answer 38

Thrombolysis - if present within 4.5 hours Thrombecomy

Question 39

Early management or stroke?

Answer 39

Concentrates on: Swallowing Fluids and oxygen Early therapy involvement Good nursing care Aspirin

Question 40

When can you manage stroke with thrombolysis?

Answer 40

Pt present within 4.5 hours

Question 41

Thrombectomy?

Answer 41

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

Question 42

When is thrombectomy used?

Answer 42

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

Question 43

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

Answer 43

Likelyhood of TIA within 1 month is high

Question 44

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

Answer 44

Anticoagulants - DOACs for AF Antiplatelets - aspirin and clopidogrel Antihypertensives - important as this is a major cause of stroke Statins Carotid endarterectomy

Question 45

Medication for AF in relation to stroke?

Answer 45

DOACs and warfarin

Question 46

Effect of stroke and dentistry?

Answer 46

Arm function Swallow problems DOACs Polypharmacy - xerostomia Not able to understand or comprehend - can’t prompt and do that

Question 47

Effect of poor oral care and systemic health?

Answer 47

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