Brainscape's Knowledge GenomeTM

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


See full index

724: Medical Lectures > Transient Ischemic Attack > Flashcards

Transient Ischemic Attack Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What are Transient ischemic attacks characterized by?

A

focal ischemic cerebral neurologic deficits that last for < 24 hours

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

How long does a TIA usually last?

A

less than 1-2 hours

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

__% of patients with stroke have a history of transient ischemic attacks

A

30%

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

What is an important cause of TIA?

A

embolization

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

What 2 locations are emboli apparent?

A
  • heart

- extracranial arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the cardiac causes of embolic ischemic attacks?

A
  • atrial fibrillation
  • rheumatic heart disease
  • mitral valve disease
  • infective endocarditis
  • atrial myxoma
  • mural thrombi complicating myocardial infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are paradoxical emboli?

A

Emboli that travel from the veins to the brain through atrial septal defects and patent foramen ovale

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

An ____ plaque on a major artery to the brain may also serve as a source of emboli

A

ulcerated

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

Where is atherosclerosis most commonly seen? What does this cause?

A

in the Carotid bifurcation extracranially

causes a bruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patients with what disease have an increased risk of developing transient ischemic deficits or strokes?

A

AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 4 other less common abnormalities of blood vessels that may cause a TIA?

A
  • Fibromuscular dysplasia
  • atherosclerosis of the aortic arch
  • inflammatory arterial disorders such as giant cell arteritis, SLE, polyarteritis, and granulomatous angiitis
  • Meningovascular syphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Although hypotension may cause a reduction of cerebral artery blood flow if a major extracranially artery to the brain is stenosed, this is a ____ source of TIA

A

rare

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

Other than what has already been listed, list 4 other disorders that can cause a TIA

A
  • polycythemia
  • sickle cell disease
  • hyperviscosity syndromes
  • severe anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Subclavian ____ syndrome may lead to transient vertebrobasilar ischemia.

A

steal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do symptoms of subclavian steal syndrome arise?

A

When there is localized stenosis or occlusion of one subclavian artery proximal to the source of the vertebral artery, so that blood is “stolen” from it.

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

What are the signs and symptoms of subclavian steal syndrome?

A
  • bruit in the supraclavicular fossa
  • unequal radial pulses
  • difference of 20 mm Hg or more between the systolic blood pressures in the arms
17
Q

What do specific symptoms of a TIA depend on?

A

the arterial distribution affected

18
Q

The risk of stroke is high in the first _ months after an attack, particularly in the _ month and especially within the first __ hours

A

3

first

48

19
Q

There is a higher risk for stroke with what type of attack?

A

carotid ischemic attacks

20
Q

Stroke risk is greatest in patients __ years of older and those who have ______.

A

60

diabetes

21
Q

Stroke risk is greatest after transient ischemic attacks that last longer than __ minutes and with symptoms or signs of weakness, speech impairment, or gait disturbance.

A

10

22
Q

What imaging technique is indicated within the first 24 hours of symptom onset?

A

CT and MRI

23
Q

What type of MRI is particularly sensitive for revealing acute or subacute infarction?

A

MRI with diffusion-weighted sequences

24
Q

What imaging technique is especially useful for detecting significant stenosis of the internal carotid artery?

A

carotid duplex ultrasonography

25
Q

What does an invasive cerebral arteriography allow for?

A

angioplasty or other interventions if necessary

26
Q

____ monitoring is indicated id a transient, paroxysmal disturbance of cardiac rhythm is suspected

A

Holter

27
Q

What are the 3 differential diagnoses of TIA?

A
  • Focal seizures
  • Classic migraine
  • Focal neurological deficits due to hypoglycemia
28
Q

What is a commonly used method to assess recurrence risk?

A

ABCD2 score

29
Q

An ABCD2 score of _ or more points has been suggested as a threshold for hospital admission.

A

3

30
Q

What is medical treatment aimed at?

A

preventing further attacks and stroke

31
Q

When treating causes such as diabetes mellitus, hematologic disorders, and hypertension what medication is typically preferred?

A

an angiotensin-­converting enzyme inhibitor or angiotensin receptor blocker

32
Q

What other drug should also consider being started?

A

statins

33
Q

What are 3 lifestyle changes that patients should adopt?

A
  • Smoking cessation
  • Weight reduction
  • Regular physical activity
34
Q

When is cardioembolism from the heart an indication for anticoagulation as a preventive treatment for stroke?

A

When is in the setting of atrial fibrillation

35
Q

What drugs are indicated for the treatment of embolism from the heart?

A

anticoagulants

36
Q

List the 4 drugs prescribed in noncardiacembolic attacks

A
  • Low-dose aspirin (81 mg)
  • Dipyridamole
  • Clopidegrol
  • Cilostazol
37
Q

When are surgical or endovascular measures indicated?

A

When arteriography reveals a surgically accessible high grade stenosis (70-99% in luminal diameter)

38
Q

Surgical or endovascular measures have moderate benefit is patients with __-__% stenosis and no benefit in mild stenosis less than __%

A

50-69

50

724: Medical Lectures (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions