Acute Stroke Care Flashcards

What is the recommended glucose target range in acute ischemic stroke patients to prevent worsening outcomes?

Answer: 140–180 mg/dL

Hyperglycemia worsens stroke outcomes; AHA/ASA guidelines recommend treating glucose > 180 mg/dL and maintaining levels of 140–180 mg/dL.

A patient with acute ischemic stroke has a temperature of 38.6°C. Which intervention is most appropriate?

Answer: Acetaminophen to reduce fever toward normothermia

Fever increases cerebral metabolic demand and worsens ischemic injury; antipyretics (e.g., acetaminophen) should be used to achieve normothermia.

Which of the following is the MOST sensitive early imaging modality for detecting acute ischemic stroke within the first few hours of onset?

Answer: Diffusion-weighted MRI (DWI)

DWI-MRI detects cytotoxic edema within minutes of ischemia onset and is far more sensitive than CT in the hyperacute phase.

A patient is eligible for IV tPA. The dose of alteplase for acute ischemic stroke is:

Answer: 0.9 mg/kg IV, max 90 mg

The standard dose is 0.9 mg/kg (maximum 90 mg), with 10% given as an IV bolus over 1 minute and the remainder over 60 minutes.

What oxygen saturation target should be maintained in acute ischemic stroke patients without hypoxia?

Answer: SpO₂ > 94%; do not give supplemental O₂ if already ≥ 94%

Supplemental oxygen is indicated only if SpO₂ < 94%; routine hyperoxia provides no benefit and may be harmful.

Which statement about permissive hypertension in acute ischemic stroke is CORRECT?

Answer: BP up to 220/120 mmHg may be tolerated in non-tPA candidates to maintain penumbral perfusion

In non-tPA-eligible patients, BP up to 220/120 mmHg is generally tolerated to preserve collateral flow to the ischemic penumbra.

The Cincinnati Prehospital Stroke Scale (CPSS) assesses three findings. Which set is correct?

Answer: Facial droop, arm drift, speech abnormality

The CPSS evaluates facial droop, arm drift, and speech abnormality — any one abnormal finding indicates high stroke probability.