Practice Test Geeks(ASC) Advanced Stroke Coordinator Certification Practice Test
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Acute Stroke Care & Treatment Flashcards

7 cards from real ASC 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. The DAWN and DEFUSE-3 trials extended mechanical thrombectomy eligibility to patients presenting up to how many hours after last known well?

    Answer: 24 hours

    The DAWN trial extended thrombectomy to 24 hours using clinical-imaging mismatch criteria, while DEFUSE-3 extended to 16 hours using perfusion imaging.

  2. Which imaging modality is MOST useful for identifying the ischemic penumbra (salvageable brain tissue) in late-presenting stroke patients?

    Answer: CT perfusion or MRI perfusion-diffusion mismatch

    CT perfusion or MRI perfusion-diffusion mismatch identifies penumbra (at-risk but viable tissue) versus core infarct for late-window treatment decisions.

  3. A 70-year-old patient on warfarin with INR of 1.6 presents with acute ischemic stroke within 3 hours. What is the appropriate tPA decision?

    Answer: Administer tPA — INR < 1.7 is acceptable

    IV tPA may be given to patients on warfarin if the INR is ≤ 1.7, as this level does not confer excessive hemorrhagic risk.

  4. What is the recommended door-to-needle time target for IV tPA administration in acute ischemic stroke?

    Answer: 60 minutes

    The AHA/ASA recommends a door-to-needle time of ≤ 60 minutes for IV tPA to maximize treatment benefit.

  5. Aspirin therapy after acute ischemic stroke treated with IV tPA should be initiated at what time point?

    Answer: At 24 hours post-tPA after repeat CT shows no hemorrhage

    Antiplatelet agents should be withheld for 24 hours after tPA and initiated only after repeat imaging confirms no hemorrhagic transformation.

  6. Which intervention is recommended for large hemispheric infarction (malignant MCA syndrome) in patients under age 60 to reduce mortality?

    Answer: Decompressive hemicraniectomy

    Decompressive hemicraniectomy within 48 hours significantly reduces mortality in malignant MCA infarction in patients ≤ 60 years old.

  7. A patient receives mechanical thrombectomy with successful TICI 2b reperfusion. What blood pressure target is recommended in the first 24 hours post-procedure?

    Answer: < 140/90 mmHg

    Following successful reperfusion, blood pressure should be maintained below 140/90 mmHg to reduce reperfusion injury and hemorrhagic transformation.