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Chapter 11. Stroke

Which one of the following is true regarding the use of heparin and low–molecular weight heparins (LMWHs) in acute ischemic stroke?

A. Should be used emergently in all patients

B. Increase the risk of hemorrhagic conversion

C. Should be administered preferentially instead of IV alteplase

D. Improve outcomes in most patients if dosed properly

E. Should be used in the acute setting if IV alteplase is not an option

A 62-year-old Hispanic woman had a stroke 2 years ago. She presents to clinic complaining of several episodes of “not being able to get the words out” over the past 2 days. She has had gastrointestinal upset with ASA in the past and is currently being treated for peripheral arterial disease and arthritis. Which one of the following medications would be the most appropriate for stroke prevention in this patient?

A. Ticlopidine 250 mg twice daily

B. Clopidogrel 75 mg daily

C. ASA and ER dipyridamole 25/200 mg twice daily

D. ASA 50 mg daily

E. No treatment is necessary

A 64-year-old African American woman with a history of ischemic stroke several months ago was previously prescribed ASA 325 mg daily, but developed an allergy to ASA and stopped taking it 2 weeks ago. Which one of the following is the most appropriate recommendation at this time?

A. Make no change at this time

B. Change the ASA dose from 325 mg daily to 50 mg daily

C. Discontinue ASA and begin clopidogrel 75 mg daily

D. Restart ASA 325 mg every other day

E. Discontinue ASA and begin ticlopidine 250 mg twice daily

Which one of the following is the most important diagnostic test for ischemic and hemorrhagic stroke?

A. Carotid Doppler studies

B. Transthoracic echocardiogram

C. Transcranial Doppler

D. CT scan of the head

E. MRI of the neck

A 68-year-old male patient is admitted to the acute stroke unit for IV alteplase approximately 2.5 ...

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