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Acute Stroke Care Flashcards

7 cards from real ACLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Acute Stroke Care flashcards as text

  1. A patient presents with sudden onset aphasia and right-sided weakness. CT head shows no hemorrhage. Last known well was 90 minutes ago. What is the next priority intervention?

    Answer: Perform CT angiography to evaluate large vessel occlusion

    CT angiography should be obtained to assess for large vessel occlusion (LVO), which determines eligibility for mechanical thrombectomy in addition to IV tPA.

  2. Which blood pressure threshold must be achieved and maintained BEFORE administering IV alteplase for acute ischemic stroke?

    Answer: < 185/110 mmHg

    BP must be < 185/110 mmHg before alteplase administration and maintained < 180/105 mmHg for at least 24 hours afterward.

  3. A 78-year-old patient with known atrial fibrillation on warfarin presents with acute ischemic stroke. INR is 1.7. Is IV tPA indicated?

    Answer: Yes, INR < 2.0 permits tPA administration

    IV tPA can be given if INR is ≤ 1.7; an INR > 1.7 in a patient on warfarin is a contraindication.

  4. What is the maximum time window for mechanical thrombectomy in selected patients with large vessel occlusion and favorable imaging?

    Answer: 24 hours from onset

    Trials (DAWN, DEFUSE 3) support mechanical thrombectomy up to 24 hours from last known well in selected patients with target mismatch on imaging.

  5. During stroke assessment, a patient scores 4 points on the Los Angeles Prehospital Stroke Screen (LAPSS). What does this indicate?

    Answer: Stroke is likely; activate the stroke team immediately

    A positive LAPSS (all criteria met) indicates high likelihood of stroke, prompting immediate stroke team activation and transport to a stroke center.

  6. Which finding on non-contrast CT head is an absolute contraindication to IV tPA in acute ischemic stroke?

    Answer: Hemorrhagic transformation

    Any intracranial hemorrhage on CT is an absolute contraindication to IV tPA administration.

  7. A stroke patient receiving IV alteplase develops sudden severe headache, hypertension, and neurological deterioration 45 minutes into the infusion. What is the immediate action?

    Answer: Stop the infusion and obtain emergent CT head

    Symptomatic intracranial hemorrhage must be suspected; the tPA infusion should be stopped immediately and emergent CT obtained.