Morning Need Help Question & Answer Guide (With Explanation)
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Original Question
ood morning. I need help putting this in a PowerPoint. I still need to use the articles and cite the authors, but I need to be more specific, use better wording, and express myself better. THANK YOU SO MUCH! DIAGNOSIS: Transient Ischemic Attacks (TIA) Risk Factors Poor controlled arterial hypertension Smoking Insulin resistant Diabetes Mellitus Polycythemia Thrombocythemia High total cholesterol Low high-density lipoprotein (LDL) cholesterol Elevated lip[protein Carotid Artery Disease Chronic Kidney disease Obesity Carotid occlusion, artery stenosis, cardiogenic embolism, intracranial more extensive artery atherosclerosis Research has demonstrated that both exercise and a reduction in cardiovascular disease (CVD) risk factors (i.e., high blood sugar, blood lipids, and blood pressure), following a stroke or transient ischemic attack (TIA) are beneficial for reducing risk of recurrent stroke or TIA and for improving overall quality of life. Despite this evidence, many stroke and TIA survivors remain inactive and sedentary and present with multiple CVD risk factors. Pathophysiology and Etiology Usually last a short period of time (< 24 hours) Neurologic symptoms present Focal brain, spinal cord, or retinal ischemia No infarction of tissue Symptoms vary based on location of ischemia Caused by interruption of blood flow to a local portion of the brain Most TIAs last less than one hour; TIAs that last longer are most often associated with brain infarction Risk of permanent tissue injury (i.e. infarction) even when focal transient neurologic symptoms last less than one hour. Signs and Symptoms The neurologic symptoms are present, but it's more like a focal brain, spinal cord, or retinal ischemia, so it should not be as intense. Symptoms vary based on the location of ischemia. Patients with transient ischemic attack (TIA) occasionally show nonfocal symptoms, such as unconsciousness, amnesia, and unsteadiness. Hemiparesis, numbness, sudden confusion, loss of balance, loss of vision, speech disturbances, sudden severe headache Diagnostic tests or labs An MRA of the head is done to look at the blood vessels leading to the brain to check for a bulge (aneurysm), a clot, or a narrowing (stenosis) because of plaque. CTA This test uses X-rays to provide detailed pictures of the heart and the blood vessels that go to the heart, lungs, brain, kidneys, head, neck, legs, and arms. A transcranial Doppler is a non-invasive, painless neurovascular ultrasound using high-frequency sound waves. A TCD measures the rate and direction of blood flow inside the arteries of the circle of Willis. Impact on other body systems TIAs are warning signs to seek medical evaluation as the patient is at an increased risk of having a stroke. Medical evaluation will help to identify the underlying cause of the TIA and plan the most effective treatment options to minimize the risk of developing a stroke. Usually, they are left with fatigue and aphasia, improvement of mental health services, and increased support for carers. Treatment options The goal is to make sure ischemia doesn't turn into an infarct. Address the underlying cause of TIA if identified: • Carotid occlusion, artery stenosis, cardiogenic embolism, intracranial more considerable artery atherosclerosis Lifestyle modification: • Healthy diet, increased activity/exercise, smoking cessation Goals for Stroke Prevention Medication options: • Monitor and control blood pressure with antihypertensives as appropriate • Statins • Antiplatelets. References Bartsch, B., Faulkner, J., Moore, J. B., & Stoner, L. (2023). Exercise prescription, intervention, dissemination, and implementation following transient ischemic attack or stroke: Advancing the field through interdisciplinary science. Translational Behavioral Medicine, 13(5), 309-315. https://doi.org/10.1093/tbm/ibac107 Ishanka Weerasekara, Jasmine Baye, Meredith Burke, Gary Crowfoot, Gillian Mason, Rachael Peak, Dawn Simpson, Frederick Rohan Walker, Michael Nilsson, Michael Pollack, & Coralie English. (2021). What do stroke survivors' value about participating in research and what are the most important research problems related to stroke or transient ischemic attack (TIA)? A survey. BMC Medical Research Methodology, 21(1), Ishihara, T., Sato, S., Uehara, T., Ohara, T., Hayakawa, M., Kimura, K., Okada, Y., Hasegawa, Y., Tanahashi, N., Suzuki, A., Nakagawara, J., Arii, K., Nagahiro, S., Ogasawara, K., Uchiyama, S., Matsumoto, M., Iihara, K., Toyoda, K., & Minematsu, K. (2018). Significance of Nonfocal Symptoms in Patients With Transient Ischemic Attack: The PROMISE-TIA Study. Stroke, 49(8), 1893-1898. https://doi.org/10.1161/STROKEAHA.118.022009
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