GP Vivas · neurological-presentations
TIA and minor stroke — structured viva
Structured oral on TIA and minor stroke: defending the 24-hour referral standard with EXPRESS data, ABCD2 and its limits, the CHANCE–POINT dual antiplatelet trade-off, carotid endarterectomy thresholds, and AF timing.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A colleague says TIAs are reassuring because the symptoms went away. Talk me through why that sentence could kill someone.' The viva branches through risk, urgency, drugs, surgery and the five-year tail.
Stem
You are the GP. A colleague says: "The symptoms resolved — that's the good news." [3]
References8ShowHide
- [1]Johnston SC, Rothwell PM, Nguyen-Huynh MN, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack Lancet, 2007.PMID 17258668
- [2]Rothwell PM, Giles MF, Flossmann E, et al. A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack Lancet, 2005.PMID 15993230
- [3]Rothwell PM, Giles MF, Chandratheva A, et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study) Lancet, 2007.PMID 17928046
- [4]Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack (CHANCE) N Engl J Med, 2013.PMID 23803136
- [5]Johnston SC, Easton JD, Farrant M, et al. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA (POINT) N Engl J Med, 2018.PMID 29766750
- [6]Rothwell PM, Eliasziw M, Gutnikov SA, et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis Lancet, 2003.PMID 12531577
- [7]Rohner R, Kneihsl M, Goeldlin MB, et al. Early Versus Late Initiation of Direct Oral Anticoagulants After Ischemic Stroke in People With Atrial Fibrillation (ELAN) Circulation, 2024.PMID 38753452
- [8]Amarenco P, Lavallée PC, Monteiro Tavares L, et al. Five-Year Risk of Stroke after TIA or Minor Ischemic Stroke N Engl J Med, 2018.PMID 29766771