Stroke MCQZ Quiz Part 2

Question 15: A 55 year old patient known diabetic, hypertensive , had dyslipidemia presented with acute ischemic stroke. After the acute period he is planned to discharge home. Advising him about medication at discharge for secondary prevention of stroke. which is true. f. Aspirin at the dose of 150 milligram is superior to aspirin 75 milligr g. Aspirin at low doses has been found to be equally effective to higher doses of Aspirin. h. There was significant difference in risk of bleeding when Aspirin <100 mg is compared to dose >100 mg . i. There was no significant difference when dose <200 mg compared to >200 mg j. All patients should be tested for aspirin resistance before starting it. Question 16: A 65 years old patient DM, HTN and had history of IHD admitted with ischemic stroke. You plan to start him on antiplatelet medication for secondary stroke prevention. Which of the following statement is true. k. Clopidogrel Is superior to the aspirin alone. l. Aspirin plus extended release dipyridamole are superior to the clopidogrel alone. m.clopidogrel nd aspirin are equally effective in stroke prevention. n. Clopidogrel and aspirin are equally effective when used in prepheral arterial disease. o. Bleeding risk for Aspirin plus clopidogrel is same as aspirin or clopidogrel used alone. Question 17: A 75 years old male presented with slurred speech and was diagnosed as having a lacunar infarct on MRI. He had this event despite being on single antiplatelet. You decide to start dual antiplatelet.which of the following is true about the dual antiplatelet therapy in show p. Dual antiplatelet therapy is superior to the single antiplatelet agent for secondary stroke prevention. q. there is no significant difference in bleeding risk with dual antiplatelet compared with any single antiplatelet r. Dual antiplatelet therapy is used for the long term, secondary prevention of ischemic stroke. s. benefit of dual antiplatelet in non cardioembolic stroke is short live t. Dual antiplatelet therapy is as effective as oral anticoagulation in cardioembolic stroke. Question 18: A patient with history of atrial fibrillation presented with ischemic stroke. He has been on tablet warfarin 5mg daily. His INR has been mostly below theTTR. you want to shift pt from warfarin to NOAC.which is true. a. Start Apiban and davigatren when INR is below 3. b. Started rivaroxiban when INR is below 2. c. Start endoxaban when INR is below 3. d. Start Apixaban when INR is below 2. e. Start rivaroxiban when INR <1.5. Question 19: A patient with history of non valvular A fib was started on NOAC. He is having affordability issue and can’t go on with these. You discuss with him about shifting from NOAC to warfarin. Which is true. u. In shifting from rivaroxiban to warfarin .. it should be stopped when INR in range v. Apixaban should be continued for 2 days and then check INR. w. Apixaban should be stopped if INR >3 x. Apixaban should be stopped when INR >2. y. apixaban should be stopped when INR >1.5. Question 20: A patient with DM, HTN presented to ER with Right MCA infarct. There is no contraindications to TPA and his CT brain is unremarkable. He. Is with in the window for TPA.which is true about acute reperfusion therapy in stroke . a. Patient taking oral anticoagulation presenting with stroke can benefit from IV tpa at 3-4.5 hours. b. patient with NIHSS >25 can benefit from IV TPA at 3-4.5 hours. c. In selected cases IV TPA window can be extended from 4.56 ho d. Mechanical thrombectomy can be performed beyond 24 hours window in posterior circulation infarct e. Imaging criteria should use to select pt for MT within 24 hours. Question 21: A 90 years old male with DM, HTN, Dyslipidemia and IHD presented with suspicion of TIS. Which of the following clinical features show the most probable schemes? If the. a. Drop attacks. b. Vertigo c. Dysphagia d. Unilateral Sensory Symptoms. e. Amarosis fugax. Question 22: A patient presented with ischemic stroke within the window period of 3-4.5 hours. which of the following is true of thrombolytic therapy in this patient a. Age is not a contraindication to thrombolytic therapy b. TPA is contraindicated in patient taking warfarin but not newer agent c. TPA is contraindicated in patients taking any anticoagulant. d. Patient with higher NIHSS score (>25)are more suitable candidate for thrombolytic therapy. e. History of previous strokes or diabetes is not considered as contraindication to TPA in this pt Question 23: The patient presented with chemic stroke. Within 6 to 24 hours window, which of the following?Makes it more likely candidate for mechanical thrombectomy. a. Infarct involving M2 or distal branches of MCA. b. NIHSS score less than six. c. Low aspect score. Of less than five. d. patient with large core infarct. e. Infarct with large ischemic penambra. Question 24: The patient presented with chemic stroke. Within 6 to 24 hours window of the following? Is true about. mechanical thrombectomy a. Mechanical thrombectomy is contraindicated if pt is already given IV TPA. b. There is increased risk of bleeding if a mechanical treatment is combined with IV TPA. c. Mechanical thrombectomy combined With IV TPA have better outcome. d. There is Contraindication to mechanical thrombectomy if patient is using oral anticoagulant. e. Patient already using dual antiplatelets have high risk of bleeding with mechanical thrombectomy. Question 25: A 65 years old pt presented with aphasia and right sided weakness. He had am infarct of superior division of MCA. Which of the following show the cardiembolic origin of the stroke? a. Stuttering or stepwise progression b. History of recurrent Tia before the stroke event. c. Stroke with onset during sleep. d. Evidence of peripheral arterial disease. e. Hemorrhagic Conversion of the infact. Question 26: 65 years old pt presented with aphasia and right sided weakness. He had am infarct of superior division of MCA. Which of the following show the large artery origion of the stroke? a. Abrupt onset of this schematic event. b. Hemorrhagic Conversion of the infarct. c. Deficit rapidly clearing over time d. No significant stenosis found on arterial Doppler/Angiogram. e. stuttering was stepwise progression of in fact Question 27: A patient presented with sudden onset left sided weakness. You suspect acute ischemic stroke. He is within window period for TPA. You use NIHSS scale to asses severity of stroke. In assessing these stroke, by NIHSS scale? Which of the following is true? a. NIHSS is best scale to be used in pre hospital setting. b. NIHSS score less than 10 refers to mild stroke. c. NIHSS Score greater than 25 refers to the severe severe stroke. d. A score of 0 excludes the stroke. e. Posterior circulation and right sided are not represented well.