ASC Evidence-Based Stroke Protocols 2

Question 1

According to AHA/ASA guidelines, what is the maximum acceptable door-to-CT time for acute ischemic stroke patients?

Accepted Answer

25 minutes

Answer

AHA/ASA guidelines recommend a door-to-CT completion time of ≤25 minutes for acute ischemic stroke patients.

Question 2

Which imaging modality is considered the gold standard for detecting acute ischemic stroke within the first 24 hours?

Accepted Answer

MRI with DWI sequence

Answer

MRI with diffusion-weighted imaging (DWI) is the gold standard for detecting acute ischemic stroke, showing restricted diffusion within minutes of onset.

Question 3

In the DAWN and DEFUSE 3 trials, patient selection for late-window thrombectomy (6–24 hours) was primarily based on:

Accepted Answer

Perfusion imaging mismatch (clinical-core or perfusion-core)

Answer

Both DAWN and DEFUSE 3 used perfusion imaging mismatch criteria (clinical-core or perfusion-core) to identify patients with salvageable penumbra beyond 6 hours.

Question 4

A patient presents with acute ischemic stroke and BP of 195/105 mmHg. Per AHA guidelines, when is antihypertensive treatment indicated before IV tPA administration?

Accepted Answer

BP ≥ 185/110 mmHg

Answer

AHA guidelines require blood pressure to be lowered to <185/110 mmHg before administering IV alteplase to reduce hemorrhagic transformation risk.

Question 5

Which of the following represents the correct alteplase dosing for acute ischemic stroke?

Accepted Answer

0.9 mg/kg IV, max 90 mg

Answer

The standard alteplase dose is 0.9 mg/kg (maximum 90 mg total), with 10% given as a bolus and the remaining 90% infused over 60 minutes.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC Evidence-Based Stroke Protocols 2