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NAPLEX - Stroke Exam Questions with correct Answers 2024/2025( A+ GRADED 100% VERIFIED).
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NAPLEX - Stroke Exam Questions with correct Answers 2024/2025( A+ GRADED 100% VERIFIED).
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NAPLEX - StrokeCVA or an ischemic stroke is also called a ____ stroke to signify that it didn't originate from the
heart - ANS non-cardioembolic
What's a cardioembolic stroke? - ANS ischemic stroke where the embolus forms in the heart
and travels to the brain
What's the most common cause of cardioembolic stroke? - ANS atrial fibrillation
List the risk factors for stroke - ANS -hypertension
-afib
-gender (female > male)
-ethnicity (highest in AA)
-age 55 or older
-atherosclerosis
-DM
-Prior stroke or TIA
-Smoking
-dyslipidemia
-PFO
-sickle cell disease
TIA
-cause - ANS temporary clot or blocked blood flow in the brain
TIA
-duration of sx - ANS Disappear on their own within mins to few hours
True or False:
TIA causes permanent damage - ANS False!
There's no permanent damage usually
Should patients seek medical attention if they have a TIA? Why? - ANS Yes! TIAs are often a
warning for future full stroke
What's the recommended time frame for someone with a possible stroke to get a CT? - ANS 20
mins
Which tPA is FDA approved to treat ischemic stroke? - ANS Alteplase
, (Tenecteplase is made by the same company but it's not FDA approved for stroke --sus)
What's the door to needle time to receive tPA? - ANS 60 mins
What's the general guideline for patients to receive tPA? How is that different from the FDA
approved timeline? - ANS 4.5 hours of sx onset
FDA: 3 hours of sx onset
What BP reading would be contraindicated to use tPA in patients with stroke? - ANS BP >
185/110 mmHg
During the first 24 hours after a stroke, what's the BP goal? - ANS < 180/105 mmHg
What's the INR level that would be contraindicated to use tPA in stroke patients? - ANS INR >
1.7
What's the dose for alteplase for stroke? - ANS 0.9 mg/kg (max 90 mg)
-give 10% as bolus over 1 min then infuse the remainder over 60 mins
What must be ruled out before using alteplase? - ANS intracranial hemorrhage
What are the contraindications for alteplase? - ANS -recent stroke within the past 3 months
-active internal bleeding
-severe uncontrolled hypertension (BP > 185/110)
-INR > 1.7 or aPTT > 40 sec
-BG < 50
-use of direct thrombin inhibitor or Xa inhibitor within *48 hours*
-use of LMWH (treatment dose) within 24 hours
When should aspirin be given in patients with stroke? What does? - ANS 162-325 mg within
24-48 hours
If a patient with a stroke received fibrinolytic, when should they get aspirin? - ANS > 24 hours
after fibrinolytic
What agents are commonly used to lower BP in stroke patients? - ANS -Labetalol IV
-nicardipine
-clevidipine
How quickly should you lower BP during the first 24 hours after a stroke onset? - ANS 15%
reduction
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