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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.

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  1. A patient with acute stroke is found to have a platelet count of 85,000/μL. IV tPA is being considered. What is the correct action?

    Answer: Withhold tPA; platelet count < 100,000/μL is a contraindication

    Platelet count < 100,000/μL is a contraindication to IV tPA in acute ischemic stroke due to increased hemorrhage risk.

  2. Which type of stroke most commonly results from cardioembolic sources such as atrial fibrillation?

    Answer: Cardioembolic stroke

    Atrial fibrillation causes cardioembolism, typically producing large cortical infarcts often involving multiple vascular territories.

  3. After IV tPA, when should antiplatelet therapy (aspirin) be initiated in acute ischemic stroke?

    Answer: 24 hours after tPA, once imaging excludes hemorrhage

    Antiplatelet agents should be withheld for 24 hours after tPA administration; a repeat CT should confirm no hemorrhage before starting.

  4. A 55-year-old patient presents with sudden onset of the 'worst headache of my life.' CT head is normal. What is the next diagnostic step?

    Answer: Lumbar puncture to detect xanthochromia

    A normal CT does not exclude subarachnoid hemorrhage; lumbar puncture should be performed to detect xanthochromia when SAH is suspected.

  5. In a patient with hemorrhagic stroke due to warfarin, which reversal agent is preferred for rapid INR correction?

    Answer: 4-factor prothrombin complex concentrate (4F-PCC)

    4F-PCC rapidly reverses warfarin anticoagulation with smaller volume than FFP and faster INR correction, making it preferred in hemorrhagic stroke.

  6. What NIHSS score range generally indicates a SEVERE stroke?

    Answer: ≥ 21

    NIHSS ≥ 21 indicates very severe stroke; scores 1–4 are minor, 5–15 moderate, and 16–20 moderate-to-severe.

  7. Which intervention should be avoided in the acute phase of ischemic stroke to prevent worsening cerebral ischemia?

    Answer: Aggressive lowering of BP below 140 systolic in non-tPA candidates

    Aggressive BP reduction below 140 mmHg in non-tPA candidates can reduce perfusion pressure in the ischemic penumbra and worsen outcomes.