Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 > Transient ischaemic attack (N) > Flashcards

Transient ischaemic attack (N) Flashcards

1
Q

Define transient ischaemic attack.

A

Temporary, focal cerebral ischaemia that results in reversible neurological deficits without acute infarction that resolves completely within 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What demographics does transient ischaemic attack happen in commonly? (2)

A
  • M>F
  • incidence increases with age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some risk factors for transient ischaemic attack? (7)

A
  • AF (most common)
  • valvular disease
  • carotid stenosis
  • congestive heart failure
  • hypertension
  • DM
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are transient ischaemic attack usually?

A

Usually embolic, may be thrombotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some causes of transient ischaemic attack? (3)

A
  • carotid atherosclerosis
  • cardioembolism - mural thromboembolism post-MI/AF, mitral valve disease, atrial myxoma, prosthetic valve
  • clots from right side of circulation can cause stroke if there is a septal defect (PFO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If there is infarction on imaging in suspected transient ischaemic attack, what does this suggest?

A

If infarction on imaging, stroke NOT transient ischaemic attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should we suspect TIA?

A

In anyone with sudden-onset focal neurological deficit that has completely resolved within 24h and cannot be explained by another condition e.g. hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How long do TIAs usually last?

A

10-15 minutes, but can be anywhere from a few minutes to 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the main clinical features of TIA? (6)

A
  • sudden-onset and brief duration of Sx (most resolve within 1h)
  • unilateral weakness or paralysis
  • dysphasia (left-sided ischaemia)
  • ataxia, vertigo or loss of balance (posterior TIA)
  • homonymous hemianopia
  • diplopia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the features of an anterior TIA (carotid territory)? (5)

A
  • unilateral
  • most often affect the motor area - weakness in arm, leg or one side of face
  • dysarthria
  • Broca’s dysphasia (if LHS)
  • amaurosis fugax (painless fleeting loss of vision caused by retinal ischaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the features of a posterior TIA (vertebrobasilar territory)? (4)

A
  • homonymous hemianopia (if ophthalmic cortex involved)
  • may have bilateral vision impairment
  • may be hemiparesis, hemisensory Sx, diplopia, vertigo, vomiting, dysarthria, dysphagia or ataxia
  • ask about unilateral weakness, facial drooping, gait disturbance, confusion, memory loss, dysarthria or abnormal behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does dysphasia indicate in TIA?

A

Left-sided ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does ataxia, vertigo or loss of balance indicate in TIA?

A

Posterior TIA (vertebrobasilar territory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What might you check for on examination in TIA? (2)

A
  • check pulse for AF
  • auscultate carotids for bruits (carotid atherosclerosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigation do we order for all patients with TIA?

A

Urgent carotid doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What scans can we do for TIA? (3)

A
  • CT head - urgently needed if patient has bleeding disorder or is on anticoagulation to exclude haemorrhage
  • MRI brain with diffusion-weighted imaging - to determine location
  • ECG - evaluate for AF and rule out myocardial ischaemia
17
Q

If there is infarction on imaging, what does this suggest in suspected TIA?

A

If infarction of imaging –> STROKE not TIA

18
Q

What bloods can we do for TIA and why? (2)

A
  • blood glucose - exclude hypoglycaemia as cause of sudden neurological Sx
  • PT, APTT, INR - exclude coagulopathy
19
Q

What score do we calculate in TIA and why?

A

ABCD2 score - estimates future stroke risk in TIA patients

20
Q

When is stroke risk highest after TIA?

A

In first 7 days following TIA –> start secondary prevention therapy immediately once TIA confirmed

21
Q

What are some differential diagnoses for TIA? (9)

A
  • stroke (>24h)
  • hypoglycaemia (BGC<3.3mmol/mol)
  • seizure with post-seizure paralysis
  • complex migraine
  • space occupying lesion (intracranial haemorrhage, abscess or mass)
  • labyrinthine disorders (BPPV, Meniere’s, labyrinthitis)
  • MS
  • peripheral neuropathy (Bell’s palsy non-forehead sparing, Ramsay-Hunt may show vesicles near tympanic membrane)
  • global hypoperfusion/syncope
22
Q

How do we manage patients with acute neurological symptoms that resolve completely within 24 hours?

A

300mg aspirin immediately + urgent assessment within 24h

23
Q

What do we do in suspected TIA if patient is on anticoagulant, or has a bleeding disorder?

A

Urgent CT head to rule out haemorrhage

24
Q

What is the gold standard treatment for TIA?

A
  • dual antiplatelet therapy (followed by clopidogrel for life):
    • aspirin 300mg loading dose, followed by 75mg for 21d
    • clopidogrel 300mg loading dose, followed by 75mg for 21d
    • then clopidogrel 75mg for life
  • high-intensity statin therapy (atorvastatin 20-80mg)
25
Q

When do we treat BP in TIA?

A

Only if >220/120 or other indication

26
Q

What do we do if patients with TIA present within vs after 7 days of episode?

A
  • within 7d: specialist review within 24h
  • after 7d: specialist review within 7d
27
Q

What antiplatelet therapy do we provide in TIA (gold standard)?

A

Dual antiplatelet therapy for 21d, followed by clopidogrel monotherapy for life

  • aspirin 300mg loading dose –> 75mg for 21 days
  • clopidogrel 300mg loading dose –> 75mg for 21 days
  • clopidogrel 75mg monotherapy for life
28
Q

What medication can be used for secondary long-term prevention of TIA?

A

Atorvastatin 80mg + antihypertensives

29
Q

What if a patient with TIA has carotid artery stenosis?

A

Carotid endarterectomy (if carotid artery stenosis >70%)

30
Q

In AF patients with TIA, what anticoagulant do we give?

A

DOAC or LMWH

31
Q

What do we give for TIA with cardiac emboli present?

A

Warfarin

32
Q

What can patients not do for at least 1 month after TIA?

A

Drive

33
Q

When is stroke risk highest post-TIA?

A

Risk of recurrent stroke is high in the first 7 days following a TIA –> start secondary prevention therapy (dual antiplatelet + statin) immediately

34
Q

What are some complications of TIA? (2)

A
  • stroke
  • MI
35
Q

Describe the prognosis of TIA.

A

By definition, a patient with a TIA has no residual symptoms from the primary event; however patients have increased risk of future ischaemic stroke

Year 3 (193 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions