2024 NAPLEX STROKE REVIEW
EXAM WITH CORRECT ANSWERS
What is an acute ischemic stroke caused by? - CORRECT-ANSWERSA
thrombus that forms during a cerebral atherosclerotic infarction. May also be
known as a non-cardioembolic stroke
What is a cardioembolic stroke? - CORRECT-ANSWERSAn ischemic stroke
that occurs when an embolus (clot) forms in the heart and travels to the
brain
What is the common cause of a cardioembolic stroke? - CORRECT-
ANSWERSAtrial fibrillation
What is a hemorrhagic stroke caused by? - CORRECT-ANSWERSa ruptured
blood vessel
What are the 3 different types of hemorrhagic strokes? - CORRECT-
ANSWERS-Intracerebral hemorrhage (ICH)
-Subarachnoid hemorrhage (SAH)
-Subdural hematoma
What drug class should be considered for secondary prevention of a
cardioembolic stroke? - CORRECT-ANSWERSanticoagulation (stroke was due
to A. fib)
What lifestyle modifications should be counseled on for secondary
prevention of ischemic stroke? - CORRECT-ANSWERS-Na restriction to < 2.4
g/day (<1.5 g/day for greater BP reduction)
-Mediterranean type-diet (emphasizing veggies, fruits, whole grains, low-fat
dairy products, poultry, legumes, and olive oils)
-Weight reduction (BMI 18.5-24.9; waist circumference < 35 in women and <
40 in men)
-Limit alcohol intake to 2 or less drinks/day in men and 1 or less drinks/day in
women
What is the recommended antiplatelet treatment in patients with a non-
cardioembolic stroke? What is recommended if the preferred treatment is
contraindicated? - CORRECT-ANSWERS-Aspirin within 24-48 hours after onset
-Clopidogrel is aspirin is contraindicated
, How long can a combo therapy with aspirin and clopidogrel be used after a
stroke? When should it be initiated? Why can't this combo therapy be used
for longer? - CORRECT-ANSWERS-21 days
-within 24 hours after a stroke
-longer increases the risk of hemorrhage
What is the MOA of dipyridamole? - CORRECT-ANSWERSInhibits the uptake of
adenosine into platelets and increases cAMP levels, which inhibits platelet
aggregation
What are the contraindications to using aspirin? - CORRECT-ANSWERS-NSAID
or salicylate allergy
-Increased risk of Reye's syndrome in children and teens
What are the warnings to using aspirin? - CORRECT-ANSWERS-Bleeding
-tinnitus (salicylate OD)
What are the common side effects of aspirin? - CORRECT-ANSWERS-
dyspepsia
-heartburn
-bleeding
-nausea
What should be prescribed in patients using chronic NSAID use and why? -
CORRECT-ANSWERS-PPIs
-used to proctect the gut
What are the risks of chronic PPI use? - CORRECT-ANSWERS-Decreased bone
density
-Increased infection risk
What is the brand name of ER dipyridamole/aspirin? - CORRECT-
ANSWERSAggrenox
What are additional warnings (in addition to aspirin warnings) for Aggrenox?
- CORRECT-ANSWERShypotension and chest pain (due to vasodilatory effects
of dipyridamole)
What are additional common side effects (in addition to aspirin side effects)
of Aggrenox? - CORRECT-ANSWERSHA
Can the the separate components of Aggrenox (ER dipyridamole and ASA) be
used if Aggrenox it self is not available? - CORRECT-ANSWERSNo. The
separate components are not interchangable with the combo product
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