TIA

Question 1

what is the main risk factor of strokes?

Answer 1

age

Question 2

definition fo TIA

Answer 2

Neurological Deficit lasting less than 24 hours attributable to Cerebral or retinal ischaemia

Question 3

what are the main causes of TIA

Answer 3

carotid artery disease/large artery disease.
Cerebral small vessel disease
Cardiac embolism.

Question 4

why is the diagnosis of TIA important of relating it to a stroke.

Answer 4

20% of strokes will be preceded by a TIA.

Can any treatment be provided to prevent a TIA becoming a stroke.

Question 5

what is the main clinical presentation of a TIA

Answer 5

loss of function

lasts for sometime and then it gets better.

Question 6

what common conditions can a stroke mimic

Answer 6

seizure,syncope(fainting), hypoglycaemia, migraines, acute confusional states.

Question 7

In an anteriror circulation stroke which blood vessels are commonly affected

Answer 7

Internal carotids

Question 8

what are the clinical feature of a anterior stroke circulation.

Answer 8

Amarausis fugax- clot in vessels going to the eyes- lose vision.

Dysphasia- Broca’s expressive, Wernicke’s- receptive.

Apraxia- cannot sequence motor function together.

Inattention- right side of brain is involved in visual spatial awareness and therefore resulting in attention to the left side of the body.

Question 9

what blood vessels are involve in posterior circulation of the brain

Answer 9

Vertebral arteries

Question 10

what are the common signs of posterior circulation of the brain.

Answer 10

Ataxia- loss of balance
Diplopia- double vision
Vertigo
Bilateral Symptoms- affects both sides of the body

Question 11

what measures are used to measure the risk of stoke post TIA

ABCD^2

Answer 11

age- over 60
BP-140/90
clinical features- unilateral weakness, speech disturbance
duration of symptoms- 60 mins, 10-50 mins, less than 10 minx
diabetes- yes/no

Question 12

are visual field defect posterior or anterior circulation defect

Answer 12

posterior

Question 13

Does a series of lots of TIA’s increase the risk of stroke

Answer 13

Yes

Question 14

how is a TIA investigated

Answer 14

History- previous TIA, cardio history
Exam- MRI, ECG, CT (to see whether posterior or anterior circulation occlusion)
Blood tests- hypoglycaemia presents similarly to TIA

Question 15

what are the secondary preventions of TIA to reduce stroke.

Answer 15

• Diet
• Exercise
• Aspirin- REDUCES THE RISK OF STROKE BY 20%
• ASP/ Dip v Asp
• Statin
• BP lowering drugs
• Warfarin
• Smoking
• Diabetic control

Question 16

what drugs does the polypill which is used to prevent stroke contain

Answer 16

• Antihypertensives
• Folic Acid
• Statin
• Aspirin

Question 17

what is Carotid Endarterectomy

Answer 17

• Cut open the vessel and remove the plaque- surgical removal of part of the inner lining of an artery, together with any obstructive deposits

Question 18

when should Carotid Endarterectomy be carried out after a stroke

Answer 18

immediately after- most effective

Question 19

what is the treatment intervention for a carotid artery occlusion

Answer 19

nothing

not possible

Question 20

the early the treatment post TIA the reduced the risk of strokes? true or false

Answer 20

True