Stroke Certification Test Prep
what is the mainstay of acute therapy for stroke? - ✔✔tPA (alteplase)
T/F: most patients don't arrive to the ED in time to receive tPA - ✔✔true
what is the time window that tPA needs to
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Stroke Certification Test Prep
what is the mainstay of acute therapy for stroke? - ✔✔tPA (alteplase)
T/F: most patients don't arrive to the ED in time to receive tPA - ✔✔true
what is the time window that tPA needs to be given in? - ✔✔within 4.5 hours of onset of
symptoms
what is the most disabling side effect of stroke therapy? - ✔✔ICH
what are 2 hallmark signs of stroke? - ✔✔one-sided weakness and drooping face
secondary prevention of stroke involves controlling/managing risk factors, ____ ____, and the
use of ___ ____ in all patients - ✔✔educating patients, antithrombotic agents (most patients will
also receive a statin and a BP lowering agent)
Stroke may be a result of cerebrovascular (____) or cardioembolic (____) sources. The final
result of both thrombus formation and embolism is an arterial ____ -> decreased cerebral blood
flow and ischemia distal to the occlusion. Thrombosis may take place in a few minutes or hours
or even days to fully evolve. A large vessel can take longer to become occluded than a smaller
vessel and there may be warning signs. One of the most important warning signs is a ____. -
✔✔thrombotic, a. fib, occlusion, TIA
where are pharmacologic interventions most likely to be effective in stroke? - ✔✔penumbra (that
zone is supplied with blood by collateral arteries but if their perfusion is not re-established
quickly then the cells in the penumbra will die too b/c collateral circulation is inadequate to
maintain the oxygen demand)
headache is more common with ___ stroke - ✔✔hemorrhagic
what are 5 factors associated with increased stroke risk? - ✔✔advanced age, DM, symptoms
more than 10 minutes, weakness, and impaired speech
ABCD^2 is a simple score used to identify individuals at high early risk of stroke after TIA,
what are the 5 categories? - ✔✔age, BP, clinical features, duration of symptoms, daibetes
how do you manage TIA? - ✔✔manage risk factors (same as for ischemic stroke)
name 4 non-modifiable risk factors for ischemic stroke - ✔✔age, race (black & hispanic), family
history of stroke/TIA, prior stroke/TIA
name 11 modifiable risk factors for ischemic stroke - ✔✔HTN, smoking, DM, asymptomatic
carotid disease, dyslipidemia, sickle cell disease, a. fib, dietary factors, physical inactivity, CAD,
HF
this is the #1 modifiable risk factors for stroke - ✔✔HTN
how should you prevent a stroke in a patient who has HTN - ✔✔follow JNC 7 guidelines for
treating HTN according to compelling indications
this is the most common arrhythmia associated with stroke - ✔✔a. fib
how do you prevent stroke in patients with a. fib? - ✔✔antithrombotics (rate control has not been
shown to prevent stroke)
how do you predict annual risk of stroke in patients with a. fib? - ✔✔CHADS2
recent data confirms that ___ is superior to ASA therapy for stroke prevention in patients with a.
fib - ✔✔warfarin
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