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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 with acute ischemic stroke is on a direct oral anticoagulant (DOAC). When can IV tPA be safely administered?

    Answer: Only if specific reversal agent was administered and coagulation assays are normal

    IV tPA may be considered after DOAC reversal (e.g., idarucizumab for dabigatran) with confirmation that coagulation tests are normal.

  2. Which ECG finding is most commonly associated with acute ischemic stroke and requires cardiac monitoring?

    Answer: Atrial fibrillation

    Atrial fibrillation is the most clinically significant arrhythmia associated with cardioembolic stroke and requires continuous monitoring to detect paroxysmal episodes.

  3. A patient with acute stroke has blood glucose of 35 mg/dL. What is the appropriate management?

    Answer: Treat hypoglycemia with IV dextrose; reassess neurological status after normalization

    Hypoglycemia (glucose < 50–60 mg/dL) mimics stroke and must be corrected immediately before attributing symptoms to ischemic stroke.

  4. The concept of 'time is brain' refers to approximately how many neurons lost per minute in untreated ischemic stroke?

    Answer: 1.9 million neurons/minute

    Approximately 1.9 million neurons are lost every minute during large vessel occlusion, underscoring the urgency of rapid reperfusion.

  5. Which of the following is a RELATIVE contraindication (not absolute) to IV tPA in acute ischemic stroke?

    Answer: Rapidly improving or minor neurological deficits

    Minor or rapidly improving symptoms are a relative contraindication; clinical judgment determines whether the deficit is disabling enough to justify tPA risk.

  6. For a suspected stroke patient in the ED, what is the AHA target time from door to CT interpretation?

    Answer: 25 minutes

    The AHA/ASA guidelines recommend CT interpretation within 25 minutes of ED arrival to facilitate rapid tPA decision-making.

  7. A stroke patient develops worsening cerebral edema on day 2 with midline shift. Which intervention may be life-saving?

    Answer: Decompressive hemicraniectomy

    Decompressive hemicraniectomy within 48 hours reduces mortality in malignant MCA infarction with significant cerebral edema and midline shift.