Practice Test Geeks(ASC) Advanced Stroke Coordinator Certification Practice Test
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Stroke Prevention & Risk Management 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. A patient with cryptogenic stroke undergoes prolonged cardiac monitoring and is found to have subclinical atrial fibrillation lasting 6 minutes. The most appropriate management is:

    Answer: Start anticoagulation therapy

    Even brief subclinical AF detected on prolonged monitoring is associated with increased stroke risk and generally warrants anticoagulation after shared decision-making.

  2. The TOAST classification system is used in stroke prevention primarily to:

    Answer: Classify ischemic stroke by probable etiology to guide secondary prevention

    The TOAST classification categorizes ischemic stroke into etiologic subtypes (large artery, cardioembolic, small vessel, other, undetermined) to direct prevention strategies.

  3. A patient is started on warfarin for AF-related stroke prevention. Target INR range is 2.0–3.0. What percentage of time-in-therapeutic-range (TTR) is considered adequate for warfarin to be preferred over switching to a DOAC?

    Answer: >65%

    A TTR consistently above 65–70% is generally required for warfarin to provide outcomes comparable to DOACs; below this threshold, switching to a DOAC is preferred.

  4. Which inherited thrombophilia is most commonly associated with increased risk of venous sinus thrombosis leading to stroke?

    Answer: Antiphospholipid syndrome

    Antiphospholipid syndrome (APS) is the most clinically significant acquired thrombophilia associated with both arterial and venous strokes, requiring long-term anticoagulation.

  5. A patient with a history of ischemic stroke presents with a new ischemic stroke while on aspirin therapy. This is referred to as:

    Answer: Aspirin resistance or treatment failure

    Recurrent ischemic events occurring despite aspirin therapy are termed aspirin resistance or aspirin treatment failure, prompting consideration of alternative antiplatelet strategies.

  6. Carotid artery stenting (CAS) is preferred over carotid endarterectomy (CEA) in which clinical scenario?

    Answer: Elderly patients >80 years with hostile neck anatomy or prior neck radiation

    CAS is favored over CEA in patients with hostile neck anatomy, prior cervical radiation, or contralateral laryngeal nerve palsy where surgical access is high risk.

  7. Which dietary pattern has the most robust evidence for primary and secondary stroke prevention?

    Answer: Mediterranean diet

    The Mediterranean diet, rich in olive oil, fish, vegetables, and nuts, has the strongest evidence for reducing cardiovascular and cerebrovascular events.