STROKE CERTIFICATION EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026
what is the mainstay of acute therapy for stroke? - Answers tPA (alteplase)
T/F: most patients don't arrive to the ED in time to receive tPA - Answers true
what is the time window that tPA needs to be given in? - Answers within 4.5 hours of onset of
symptoms
what is the most disabling side effect of stroke therapy? - Answers ICH
what are 2 hallmark signs of stroke? - Answers one-sided weakness and drooping face
secondary prevention of stroke involves controlling/managing risk factors, ____ ____, and the use of
___ ____ in all patients - Answers educating patients, antithrombotic agents (most patients will also
receive a statin and a BP lowering agent)
Stroke may be a result of cerebrovascular (____) or cardioembolic (____) sources. The final result of
both thrombus formation and embolism is an arterial ____ -> decreased cerebral blood flow and
ischemia distal to the occlusion. Thrombosis may take place in a few minutes or hours or even days to
fully evolve. A large vessel can take longer to become occluded than a smaller vessel and there may
be warning signs. One of the most important warning signs is a ____. - Answers thrombotic, a. fib,
occlusion, TIA
where are pharmacologic interventions most likely to be effective in stroke? - Answers penumbra
(that zone is supplied with blood by collateral arteries but if their perfusion is not re-established
quickly then the cells in the penumbra will die too b/c collateral circulation is inadequate to maintain
the oxygen demand)
headache is more common with ___ stroke - Answers hemorrhagic
what are 5 factors associated with increased stroke risk? - Answers advanced age, DM, symptoms
more than 10 minutes, weakness, and impaired speech
ABCD^2 is a simple score used to identify individuals at high early risk of stroke after TIA, what are the
5 categories? - Answers age, BP, clinical features, duration of symptoms, daibetes
how do you manage TIA? - Answers manage risk factors (same as for ischemic stroke)
name 4 non-modifiable risk factors for ischemic stroke - Answers age, race (black & hispanic), family
history of stroke/TIA, prior stroke/TIA
name 11 modifiable risk factors for ischemic stroke - Answers HTN, smoking, DM, asymptomatic
carotid disease, dyslipidemia, sickle cell disease, a. fib, dietary factors, physical inactivity, CAD, HF
this is the #1 modifiable risk factors for stroke - Answers HTN
how should you prevent a stroke in a patient who has HTN - Answers follow JNC 7 guidelines for
treating HTN according to compelling indications
this is the most common arrhythmia associated with stroke - Answers a. fib
how do you prevent stroke in patients with a. fib? - Answers antithrombotics (rate control has not
been shown to prevent stroke)
how do you predict annual risk of stroke in patients with a. fib? - Answers CHADS2
recent data confirms that ___ is superior to ASA therapy for stroke prevention in patients with a. fib -
Answers warfarin
trials of stroke prevention in a. fib patients found _______ to have a significantly higher risk of
bleeding than warfarin or ASA monotherapy - Answers ASA+clopidogrel (don't use it b/c we are
dealing with patients who we worry about bleeding in)
this agent is historically the best for prevention of stroke in a. fib - Answers warfarin
new oral anticoags are all approved for stroke prevention in a. fib IF _______ - Answers there are no
valvular issues
are the new oral anticoags considered to be as safe and effective as warfarin for stroke prevention in
patients with a. fib? - Answers yes (but they aren't used much due to cost and non-reversibility)
valvular heart disease can affect any of the valves of the heart and can lead to serious clinical
consequences such as HF and ___ complications like ____ - Answers thrombotic, stroke
FYI: there are many causes of valvular heart disease including rheumatic fever, congenital
abnormalities, and chronic calcifications - Answers ...
symptomatic valvular disease requires ___ or __ - Answers repair, replacement
for stroke prevention, we are most concerned with ___ or ___ valve disease - Answers aortic, mitral
___ valve disease is associated with higher risk of thrombosis than ___ valve disease - Answers mitral,
aortic
___ valves are more thrombogenic than _____valves - Answers mechanical, bioprosthetic
what is the mainstay of acute therapy for stroke? - Answers tPA (alteplase)
T/F: most patients don't arrive to the ED in time to receive tPA - Answers true
what is the time window that tPA needs to be given in? - Answers within 4.5 hours of onset of
symptoms
what is the most disabling side effect of stroke therapy? - Answers ICH
what are 2 hallmark signs of stroke? - Answers one-sided weakness and drooping face
secondary prevention of stroke involves controlling/managing risk factors, ____ ____, and the use of
___ ____ in all patients - Answers educating patients, antithrombotic agents (most patients will also
receive a statin and a BP lowering agent)
Stroke may be a result of cerebrovascular (____) or cardioembolic (____) sources. The final result of
both thrombus formation and embolism is an arterial ____ -> decreased cerebral blood flow and
ischemia distal to the occlusion. Thrombosis may take place in a few minutes or hours or even days to
fully evolve. A large vessel can take longer to become occluded than a smaller vessel and there may
be warning signs. One of the most important warning signs is a ____. - Answers thrombotic, a. fib,
occlusion, TIA
where are pharmacologic interventions most likely to be effective in stroke? - Answers penumbra
(that zone is supplied with blood by collateral arteries but if their perfusion is not re-established
quickly then the cells in the penumbra will die too b/c collateral circulation is inadequate to maintain
the oxygen demand)
headache is more common with ___ stroke - Answers hemorrhagic
what are 5 factors associated with increased stroke risk? - Answers advanced age, DM, symptoms
more than 10 minutes, weakness, and impaired speech
ABCD^2 is a simple score used to identify individuals at high early risk of stroke after TIA, what are the
5 categories? - Answers age, BP, clinical features, duration of symptoms, daibetes
how do you manage TIA? - Answers manage risk factors (same as for ischemic stroke)
name 4 non-modifiable risk factors for ischemic stroke - Answers age, race (black & hispanic), family
history of stroke/TIA, prior stroke/TIA
name 11 modifiable risk factors for ischemic stroke - Answers HTN, smoking, DM, asymptomatic
carotid disease, dyslipidemia, sickle cell disease, a. fib, dietary factors, physical inactivity, CAD, HF
this is the #1 modifiable risk factors for stroke - Answers HTN
how should you prevent a stroke in a patient who has HTN - Answers follow JNC 7 guidelines for
treating HTN according to compelling indications
this is the most common arrhythmia associated with stroke - Answers a. fib
how do you prevent stroke in patients with a. fib? - Answers antithrombotics (rate control has not
been shown to prevent stroke)
how do you predict annual risk of stroke in patients with a. fib? - Answers CHADS2
recent data confirms that ___ is superior to ASA therapy for stroke prevention in patients with a. fib -
Answers warfarin
trials of stroke prevention in a. fib patients found _______ to have a significantly higher risk of
bleeding than warfarin or ASA monotherapy - Answers ASA+clopidogrel (don't use it b/c we are
dealing with patients who we worry about bleeding in)
this agent is historically the best for prevention of stroke in a. fib - Answers warfarin
new oral anticoags are all approved for stroke prevention in a. fib IF _______ - Answers there are no
valvular issues
are the new oral anticoags considered to be as safe and effective as warfarin for stroke prevention in
patients with a. fib? - Answers yes (but they aren't used much due to cost and non-reversibility)
valvular heart disease can affect any of the valves of the heart and can lead to serious clinical
consequences such as HF and ___ complications like ____ - Answers thrombotic, stroke
FYI: there are many causes of valvular heart disease including rheumatic fever, congenital
abnormalities, and chronic calcifications - Answers ...
symptomatic valvular disease requires ___ or __ - Answers repair, replacement
for stroke prevention, we are most concerned with ___ or ___ valve disease - Answers aortic, mitral
___ valve disease is associated with higher risk of thrombosis than ___ valve disease - Answers mitral,
aortic
___ valves are more thrombogenic than _____valves - Answers mechanical, bioprosthetic
