Show notes
Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode.Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences. Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.comACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders CreditsProducers: Molly Heublein MD; Matthew Watto MD, FACPWriter (including CME questions): Molly Heublein MDCover Art: Bryan Brown MDHosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACPEditor: Emi Okamoto, MD; Matthew Watto MD, FACPGuest: Chris Favilla, MDSponsor: Indeed indeed.com/internalmedicineGet a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.Sponsor: Qalo qalo.com/curbHead to qalo.com/curb to get 20% off your purchase today.Time Stamps*Time Stamps refer to ad-free version00:00 Intro, disclaimer, guest bio, and a bad pun04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch, 07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter08:40 A case of TIA; definition of TIA12:14 Stroke territories14:24 New definition of TIA16:00 Differentiation from complex migraine19:17 Risk stratifying TIA and ABCD2 score22:00 A bit on tPA24:01 Workup for TIA; workup for amaurosis fugax25:36 CNS imaging studies after stroke or TIA; Choice of imaging study33:15 HINTS exam for posterior circulation stroke34:48 Is an echo necessary? Bubble study for PFO?38:32 Duration of afib monitoring40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers”41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC)43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant?48:50 Aspirin therapy after TIA; Dosage adjustment based on weight?51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization)57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy62:57 Antidiabetic drugs and stroke63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging71:54 Resources for stroke: Decision making in neurology textbook73:28 Outro
