WorksheetsACS & stroke practice quiz
Total questions: 24
Worksheet time: 17mins
What is the brand name of Alteplase?
Activa
Activase
Angiomax
Aggrenox
Which of the following best describes how Activase works?
Inhibit FActor Xa
Bind to fibrin and dissolves the clot
Bind to IIb/IIIa receptor and reduce platelet aggregation
Inhibitor production of vitamin K depending clotting factors
Contraindications for Alteplase include:
Concurrent use of anticoagulants
Low platelets
Active bleeding
Blood pressure 200/100 mmHg
If a patient is a candidate for Alteplase for acute ischemic stroke except that his blood pressure is very high > 185/110 mmHg, which agent can be used to lower his blood pressure stat? SATA
PO metoprolol
IV labetalol
IV nicardipine
PO enalapril
How long is the window to give Alteplase after 1st presentation of stroke symptoms?
Best within 5 hours, can still be given with 12 hours
Best within 3 hours, can still be given with 10 hours
Best within 3 hours, can still be given with 4.5 hours
Best within 4 hours, can still be given with 6 hours
A patient who is 268 lbs, what is the Alteplase dose recommended?
6m IV bolus, followed by 54 mg IV infusion over 60 minutes
90 mg IV infusion over 60 minutes
9 mg IV bolus followed by 81 mg IV infusion over 60 minutes
10.9 mg IV bolus followed by 98.67 mg IV infusion over 60 minutes
How often is Nimotop administered for hemorrhagic stroke indication?
every 12 hours
every 6 hours
every 4 hours
every 2 hours
A patient presents to the ER with chest pain that provides little relief from NTG SL, ECG shows ST depression. Troponin I is negative. LVEF is 45%. What does this patient has?
STEMI
CHF exacerbation
GERD
Unstable angina
A patient presents to the ER with chest pain that provides little relief from NTG SL, ECG shows ST depression. Troponin I is negative. LVEF is 45%.
He is on Lantus 20 units q hs, Lisinopril/HCTZ 20/12.5mg daily, Atorvastatin 20mg q hs, Aspirin 81mg daily. Vitals: BP 124/70; HR 101, R 25, Wt 100 kg, Ht 5’10” O2 Sat 92%. What medication would you add?
Aspirin 325mg chewable
Morphine 2mg IV
Metoprolol 25mg PO
Oxygen
In patients with STEMI, what is the initial strategy?
Reperfusion (PCI or fibrinolytic)
Ischemic guided therapy
Early invasive therapy
What does MONA stands for?
Morphine
Isosorbide mononitrate
Aspirin chewable
Oxygen at 4L/min for patients with O2 sat < 90%
What is the name of the cardiac marker that is most sensitive/specific for detecting myocardial injury?
CK
C-reactive protein
Troponin
ESR
What are the reperfusion strategy for a patient who has STEMI? SATA
Fibrinolysis (when no PCI available)
PCI
What is the Enoxaprin dose when being given with fibronolytic in patient < 75 year old with STEMI?
1 mg/kg SC q
12h
1.5 mg/kg SC q
12h
30mg IV bolus; 15
min later give 1 mg/kg SC qd
30mg IV bolus; 15
min later give 1 mg/kg SC q
12h (max 100mg/dose for
first 2 doses)
Which of the following P2Y12 receptor inhibitors is a prodrug activated by CYP2C19 and should be avoided with omeprazole?
Plavix
Brilinta
Effient
Which of the following P2Y12 receptor inhibitors should be avoid in patients with severe hepatic impairment?
Clopidogrel
Ticagrelor
Prasugrel
Which of the following P2Y12 receptor inhibitor is not recommended for patients > 75 years old?
Plavix
Brilinta
Effient
The first medical contact FMC to device time for PCI in patients with STEMI transported to a PCI capable hospital is
≤ _____ mins.30
60
90
120
If a STEMI patient do not access to PCI, a fibrinolytic should be given within _________ minutes of arrival to the hospital.
10
20
30
60
When do you use fibrinolytic in patients with STEMI?
A patient is going to PCI after a STEMI. What antithrombotic therapy is recommended? SATA
Anticoagulant (Heparin or Enoxaparin or Fondaparinux or Angiomax)
Aspirin 162-325mg prior to PCI
P2Y12 inhibitor
HH is a 79 years old male going to the PCI. His physician would like to put him on Clopidogrel. What is the correct dose and plan?
Clopidogrel 600mg loading dose, followed by 75mg daily for a year
Clopidogrel 300mg loading dose, followed by 75mg daily for a year
Clopidogrel 75mg daily for a year
Clopidogrel is not indicated for STEMI patients with PCI
In NSTE-ACS patient, which initial strategies are recommended? SATA
Ischemia guide strategy (med only)
Early invasive for high risk patients (PCI)
Fibrinolytic
Patients with established ACS should initiate the following secondary prevention strategies (Hint: ABCDEF)
Beta blocker
Statin
Exercise
Diabetes management, diet
Antiplatelet
