Practice Test Geeks(ASC) Advanced Stroke Coordinator Certification Practice Test
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Evidence-Based Stroke Protocols Flashcards

7 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. According to evidence-based stroke protocols, which antiplatelet regimen is recommended for secondary prevention after a minor ischemic stroke or high-risk TIA (ABCD2 ≥4)?

    Answer: Dual antiplatelet therapy with aspirin and clopidogrel for 21 days

    Based on the POINT and CHANCE trials, dual antiplatelet therapy (aspirin + clopidogrel) for 21 days significantly reduces early recurrent stroke after minor stroke or high-risk TIA.

  2. In hemorrhagic stroke management, which evidence-based target systolic BP is recommended for patients with ICH and initial SBP between 150–220 mmHg?

    Answer: SBP < 140 mmHg

    AHA/ASA guidelines support rapid lowering of SBP to <140 mmHg for ICH patients with initial SBP 150–220 mmHg, as supported by the ATACH-2 and INTERACT2 trials.

  3. Which finding on CT angiography most strongly predicts hematoma expansion in intracerebral hemorrhage?

    Answer: Spot sign (contrast extravasation within hematoma)

    The CT angiography 'spot sign' — active contrast extravasation within the hematoma — is a strong independent predictor of hematoma expansion and poor outcome.

  4. Per AHA/ASA guidelines, which patient with cryptogenic stroke has the strongest indication for prolonged cardiac monitoring (≥30 days)?

    Answer: 55-year-old with embolic stroke of undetermined source (ESUS) after negative standard workup

    Prolonged cardiac monitoring is most strongly indicated in ESUS patients without a detected source after standard workup, to detect paroxysmal atrial fibrillation.

  5. The CHANCE-2 trial demonstrated that ticagrelor-aspirin was superior to clopidogrel-aspirin for minor stroke/TIA prevention specifically in patients with:

    Answer: CYP2C19 loss-of-function variants

    CHANCE-2 showed ticagrelor-aspirin was superior to clopidogrel-aspirin in minor stroke/TIA patients carrying CYP2C19 loss-of-function alleles who have reduced clopidogrel metabolism.

  6. Evidence-based protocols for acute large vessel occlusion recommend mechanical thrombectomy up to how many hours from symptom onset in selected patients with favorable perfusion imaging?

    Answer: 24 hours

    Based on DAWN and DEFUSE 3 trials, mechanical thrombectomy can be performed up to 24 hours from symptom onset in selected patients with favorable clinical-imaging mismatch criteria.

  7. Which statement about tenecteplase (TNK) versus alteplase in acute ischemic stroke is supported by current evidence?

    Answer: TNK 0.25 mg/kg single bolus is at least as effective as alteplase for LVO patients undergoing thrombectomy

    The AcT trial and meta-analyses support tenecteplase 0.25 mg/kg as a single IV bolus as non-inferior to alteplase, particularly facilitating workflow for patients undergoing thrombectomy.