ASC ASC Stroke Pharmacotherapy & Medication Management 2

Question 1

Which oral anticoagulant class is preferred over warfarin for secondary stroke prevention in patients with non-valvular atrial fibrillation per current AHA guidelines?

Accepted Answer

Direct oral anticoagulants (DOACs)

Answer

DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over warfarin for AF-related stroke prevention due to superior efficacy and safety profiles.

Question 2

A stroke patient with atrial fibrillation and acute ischemic stroke should typically have anticoagulation initiated within what timeframe to balance stroke recurrence versus hemorrhagic transformation risk?

Accepted Answer

4–14 days after stroke depending on infarct size

Answer

Guidelines recommend initiating anticoagulation between day 4 and 14 based on stroke severity and infarct size, balancing recurrence and bleeding risk.

Question 3

Which agent is the reversal medication for dabigatran in a stroke patient with life-threatening hemorrhage?

Accepted Answer

Idarucizumab (Praxbind)

Answer

Idarucizumab is the specific reversal agent for dabigatran, a direct thrombin inhibitor, approved for emergency reversal.

Question 4

Statin therapy is recommended after ischemic stroke primarily to reduce recurrence risk through which mechanism?

Accepted Answer

Plaque stabilization and LDL reduction

Answer

Statins reduce recurrent stroke risk primarily by stabilizing atherosclerotic plaque and lowering LDL cholesterol levels.

Question 5

A patient with acute ischemic stroke not treated with tPA has a blood pressure of 220/120 mmHg. Per AHA guidelines, when should antihypertensive therapy be initiated?

Accepted Answer

Only if BP exceeds 220/120 mmHg persistently or symptomatic end-organ damage is present

Answer

For non-tPA patients, guidelines recommend withholding antihypertensives unless BP exceeds 220/120 or there is evidence of acute end-organ damage within the first 24–48 hours.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC ASC Stroke Pharmacotherapy & Medication Management 2