front 1 What condition would exclude a patient from receiving alteplase? | back 1 Mild, nondisabling stroke |
front 2 When comparing initial imaging and advanced imaging, what decision is always interpreted from initial imaging? | back 2 presence or absence of hemorrhage |
front 3 When comparing initial imaging and advanced imaging, what decision is always interpreted from initial imaging? what brain tissue is permanently damaged and what is at risk or salvageable - mismatch is good for salvage and match is bad to indicate no salvage | back 3 old infarcts - wrong Refer to: Decision from Stroke Expertise/ Image Mismatch |
front 4 What is the traditional time goal for initiation of noncontrast brain CT? | back 4 within 25 min |
front 5 What complication should you immediately suspect if a patient develops sudden hypertension and acute neurological deterioration after reperfusion? | back 5 intracranial hemorrhage |
front 6 When should EMS notify the receiving hospital of an incoming stroke patient? | back 6 prior to arrival |
front 7 When should EMS notify the receiving hospital of an incoming stroke patient? | back 7 7 |
front 8 What assessment to measure deficits must be completed by the stroke team on all suspected stroke patients as soon as possible on arrival prior to treatment? | back 8 modified Rankin mRS - wrong NIHSS - predicts lesion size, stroke severity, determines treatment, predicts outcome Refer to: Data from Workup/Arrival Screening/ Severity Assessments |
front 9 What is the recommended blood pressure before thrombolytic administration? | back 9 185/110 |
front 10 What action must an EMS dispatcher take when a caller describes symptoms of stroke? | back 10 talk caller through prehospital stroke screen |
front 11 How frequently should blood pressure be monitored at a minimum in a patient who received a thrombolytic 12 hours earlier? | back 11 q1h |
front 12 What diagnostic test is important for EMS to perform in suspected stroke patients to rule out conditions which may mimic stroke? | back 12 blood glucose test |
front 13 How frequently should blood pressure be monitored at a minimum during the first 2 hours after thrombolytic administration? | back 13 q15m |
front 14 How frequently should neuro assessments be performed at a minimum to monitor for intracranial hemorrhage during the first 2 hours after thrombolytic administration? | back 14 q15m |
front 15 What assessment to measure prestroke disability must be completed by the stroke team when determining eligibility for mechanical thrombectomy? | back 15 ASPECTS score - wrong mRS modified Rankin Refer to: Data from Workup / Arrival Screening and Severity Assessments |
front 16 What does advanced imaging with CTA/MRA provide? detects occlusion or stenosis of large vessels of head and neck; identifies aneurysm, arteriovenous malformation, cerebral venous thrombus | back 16 IV thrombolytic eligibility - wrong ASPECTS score - wrong It assists w identifying Pts wo can be treated w mechanical thrombectomy, quantifying salvageable brain tissue, and pinpointing cause of hemorrhage. Refer to: Decision from Stroke Expertise / Advanced Imaging |
front 17 What is the symptom onset time frame (LKN) for thrombolytic eligibility? | back 17 4.5 hrs |
front 18 What is a main goal of initial brain imaging (CT/MRI) in acute stroke? | back 18 rule out hemorrhage |
front 19 What is the expanded symptom onset time frame for mechanical thrombectomy eligibility? | back 19 24 hrs |
front 20 How frequently should neuro assessments be performed at a minimum to monitor for intracranial hemorrhage in a patient who received a thrombolytic 12 hours earlier? | back 20 every hour |
front 21 When considering a patient for mechanical thrombectomy whose last known normal is greater than 6 hours, what condition would deem the patient ineligible? | back 21 severe disabling stroke - wrong Incorrectly Answered: Severe disabling stroke |
front 22 What is the EMS door-in to door-out time goal for hospital-to-hospital transfer with the drip and ship model? | back 22 within 60 min |
front 23 What does the presence of a perfusion/diffusion study mismatch indicate? | back 23 salvageable brain tissue |
front 24 What unique equipment is required to be onboard a mobile stroke unit? | back 24 CT scanner |
front 25 What diagnostic test would be helpful when considering differential diagnoses for patients with signs and symptoms that mimic stroke? | back 25 toxicology screen |
front 26 What diagnostic tests must be completed before thrombolytic administration? | back 26 Blood glucose and brain CT/MRI |
front 27 What condition would include a patient for consideration to receive alteplase? | back 27 mild, disabling stroke |