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SSP 6th Flashcards

1
Q 
Lowest yield in stroke in the young work-up*
A. 2D echo
B. Holter monitoring
C. Vasculitis panel
D. CT angiography
E. Cardiac ultrasound
A

B. Holter monitoring (p. 177)

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2
Q 
Recurrence rate for stroke in the young*
A. 1.7%
B. 4.7%
C. 7.7%
D. 11.5%
A

D. 11.5% (p. 180)

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3
Q

The first major trial to investigate the effect of BP treatment for secondary stroke prevention
A. Post stroke Antihypertensive Treatment Study (PATS)
B. Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS)
C. Secondary Prevention of Small Subcortical Strokes (SPS3)
D. None of the above

A

A. Post stroke Antihypertensive Treatment Study (PATS) (p. 30)

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4
Q

Confirmed the benefit of an ACEI-based regimen in reducing the incidence of secondary stroke as well as MI
A. Post stroke Antihypertensive Treatment Study (PATS)
B. Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS)
C. Secondary Prevention of Small Subcortical Strokes (SPS3)
D. None of the above

A

B. Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS) (p. 30)

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5
Q

Randomized patients to target SBP levels of <150 mmHg vs <130 mmHg and showed that there was no difference between the target groups with regard to the composite outcome of stroke, MI, and vascular death
A. Post stroke Antihypertensive Treatment Study (PATS)
B. Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS)
C. Secondary Prevention of Small Subcortical Strokes (SPS3)
D. None of the above

A

C. Secondary Prevention of Small Subcortical Strokes (SPS3) (p. 30)

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6
Q

This study found that using metformin as first line therapy for overweight T2DM patients appears to decrease DM-related end points such as stroke
A. United Kingdom Prospective Diabetes Study (UPDS)
B. Insulin Resistance Intervention after Stroke trial (IRIS)
C. Both A and B
D. None of the above

A

A. United Kingdom Prospective Diabetes Study (UPDS) (p. 34)

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7
Q

Examined the efficacy of pioglitazone in preventing stroke recurrence
A. United Kingdom Prospective Diabetes Study (UPDS)
B. Insulin Resistance Intervention after Stroke trial (IRIS)
C. Both A and B
D. None of the above

A

B. Insulin Resistance Intervention after Stroke trial (IRIS) (p. 34)

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8
Q

Showed a trend toward reduction of stroke (primarily ischemic) with gemfibrozil (HR .75) among patients with CHD and low HDL-C levels
A. Veterans Administration HDL Intervention Trial (VA-HIT)
B. Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL)
C. Heart Protection Study (HPS)
D. Treat Stroke to Target (TST)

A

A. Veterans Administration HDL Intervention Trial (VA-HIT) (p. 39)

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9
Q

By far the only trial dedicated to the evaluation of secondary stroke risk
A. Veterans Administration HDL Intervention Trial (VA-HIT)
B. Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL)
C. Heart Protection Study (HPS)
D. Treat Stroke to Target (TST)

A

B. Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) (p. 39)

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10
Q

This study showed that there was an 18% incremental increase in stroke risk for every 5% decline in EF
A. Survival And Ventricular Enlargement study (SAVE)
B. Studies Of Left Ventricular Dysfunction trial (SOLVD)
C. Warfarin vs Asprin in Reduced Cardiac Ejection Fraction (WARCEF) trial
D. None of the above

A

A. Survival And Ventricular Enlargement study (SAVE) (p. 46)

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11
Q

This study showed a 58% increase in the risk of thromboembolic events for every 10% decrease in EF in women but no noted increase in men
A. Survival And Ventricular Enlargement study (SAVE)
B. Studies Of Left Ventricular Dysfunction trial (SOLVD)
C. Warfarin vs Asprin in Reduced Cardiac Ejection Fraction (WARCEF) trial
D. None of the above

A

B. Studies Of Left Ventricular Dysfunction trial (SOLVD) (p. 46)

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12
Q

This study showed that among patients with asymptomatic carotid stenosis (60-99%), CEA combined with best medical treatment reduced the 5-year ipsilateral stroke risk from 11% to 5.1% (RRR 5.3%)
A. Asymptomatic Carotid Artery Stenosis trial (ACAS)
B. Asymptomatic Carotid Surgery Trial (ACST)
C. European Carotid Surgery Trial (ECST2)
D. Carotid Revascularization Endarterectomy vs Stent Trial (CREST)

A

A. Asymptomatic Carotid Artery Stenosis trial (ACAS) (p. 52)

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13
Q

This study showed a small but definite reduction of stroke risk with surgery among patients with >/=60% stenosis (5-year stroke risk 11.8% in medical arm vs 6.4% in combined CEA and medical treatment arm)
A. Asymptomatic Carotid Artery Stenosis trial (ACAS)
B. Asymptomatic Carotid Surgery Trial (ACST)
C. European Carotid Surgery Trial (ECST2)
D. Carotid Revascularization Endarterectomy vs Stent Trial (CREST)

A

B. Asymptomatic Carotid Surgery Trial (ACST) (p. 52)

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14
Q

An intriguing finding of this trial showed that CAS appeared to have a greater efficacy among younger patients (<70 years) while endarterectomy was slightly superior when used in older patients
A. Asymptomatic Carotid Artery Stenosis trial (ACAS)
B. Asymptomatic Carotid Surgery Trial (ACST)
C. European Carotid Surgery Trial (ECST2)
D. Carotid Revascularization Endarterectomy vs Stent Trial (CREST)

A

D. Carotid Revascularization Endarterectomy vs Stent Trial (CREST) (p. 53)

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15
Q 
This study showed that aspirin is safer and as effective as warfarin fro stroke prevention
A. WASID
B. TOSS
C. TOSS 2
D. CLAIR
A

A. WASID (p. 57)

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16
Q 
This trial showed that adding cilostazol 100 mg BID to aspirin was superior to aspirin monotherapy in preventing progression of intracranial arterial stenosis as detected by MRA at 6 months
A. WASID
B. TOSS
C. TOSS 2
D. CLAIR
A

B. TOSS (p. 57)

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17
Q 
This trial showed that there was a non-significant trend towards less ICAD progression in patients who received cilostazol 100 mg BID in addition to standard ASA 75-150 mg
A. WASID
B. TOSS
C. TOSS 2
D. CLAIR
A

C. TOSS 2 (p. 57)

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18
Q 
This study showed that the combination of clopidogrel and aspirin was associated with significantly fewer microembolic signals on TCD at day 2 and day 7 compared with aspirin monotherapy
A. WASID
B. TOSS
C. TOSS 2
D. CLAIR
A

D. CLAIR (p. 57)

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19
Q 
ASA-treated patients had slightly fewer deaths at 14 days, significantly fewer recurrent ischemic strokes at 14 days, and no excess of hemorrhagic strokes. In heparin-treated patients, there were fewer deaths or recurrent strokes but there were more hemorrhagic strokes and serious extracranial hemorrhage.
A. IST
B. CAST
C. FASTER
D. CHANCE
E. CAIST
A

A. IST (p. 78)

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20
Q 
In this study, patients with AIS within 48 hours were randomized to ASA 160 mg OD or placebo for up to 4 weeks
A. IST
B. CAST
C. FASTER
D. CHANCE
E. CAIST
A

B. CAST (p. 78)

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21
Q 
This trial was prematurely terminated because of failure to recruit patients at a pre-specified recruitment rate due to increased use of statins
A. IST
B. CAST
C. FASTER
D. CHANCE
E. CAIST
A

C. FASTER (p. 78)

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22
Q 
This study showed that the rate of recurrent stroke at 90 days for the clopidogrel-ASA group was 8.2%, while the rate of recurrent stroke was 11.7% for the ASA only group, with no increase in rate of moderate to severe bleeding and hemorrhagic stroke with the combination treatment
A. IST
B. CAST
C. FASTER
D. CHANCE
E. CAIST
A

D. CHANCE (p. 79)

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23
Q 
This study showed non-inferiority of cilostazol over aspirin in MRS scores at 90 days among AIS patients with NIHSS < 15 within 48 hrs
A. IST
B. CAST
C. FASTER
D. CHANCE
E. CAIST
A

E. CAIST (p. 79)

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24
Q 
Patients with AIS within 12 hours were randomized to IV Cerebrolysin 30 mL daily or placebo for 10 days
A. CAIST
B. CASTA
C. ICTUS
D. CHIMES
A

B. CASTA (p. 82)

25
Q 
Patients with moderate to severe AIS within 24 h were randomized into citicoline 1g q12h or placebo for 6 weeks
A. CAIST
B. CASTA
C. ICTUS
D. CHIMES
A

C. ICTUS (p. 82)

26
Q 
Patients with AIS of intermediate severity within 72 hours were randomized to NeuroAID 4 caps TID or placebo for 90 days
A. CAIST
B. CASTA
C. ICTUS
D. CHIMES
A

D. CHIMES (p. 82)

27
Q 
Patients with AIS < 3 h were randomized to IV tPA (0.9 mg/kg) or placebo. The study showed no difference in neurologic improvement at 24 h but patients given tPA were 30% more likely than controls to have minimal or no disability at 3 months, despite more symptomatic ICH
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

A. NINDS TPA (p. 89)

28
Q 
Patients with AIS < 6 h were randomized to tPA 1.1 mg/kg or placebo
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

B. ECASS (p. 89)

29
Q 
Patients with AIS < 6 h were randomized to rTPA 0.9 mg/kg or placebo. The study showed no significant difference in the rate of favorable outcome at 3 months .
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

C. ECASS II (p. 89)

30
Q 
142 patients with acute ischemic stroke < 6 h were randomized to rTPA 0.9 mg/kg or placebo. The study showed that the risk of symptomatic ICH was increased with rTPA treatment particularly in patients treated between 5-6 h
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

E. ATLANTIS A (p. 89)

31
Q 
613 patients with AIS within 3-5 h were randomized to tPA or placebo
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

F. ATLANTIS B (p. 89)

32
Q 
Patients with AIS within 3-4.5 h were randomized to rTPA 0.9 mg/kg or placebo. Significantly more patients in rTPA-treated group had favorable outcome at 3 months. The incidence of ICH was higher with rTPA but mortality did not significantly differ between the 2 groups.
A. NINDS TPA
B. ECASS
C. ECASS II
D. ECASS III
E. ATLANTIS A
F. ATLANTIS B
A

D. ECASS III (p. 89)

33
Q 
Patients within 3 h of AIS were given 0.6 mg/kg IV rTPA as single-arm, open-label study
A. NINDS TPA
B. ECASS
C. J-ACT
D. IST III
A

C. J-ACT (p. 89)

34
Q 
Patients with AIS within 6 h were randomized to rTPA 0.9 mg/kg or placebo. More deaths occurred during the first 7 days in the rTPA treated group.
A. NINDS TPA
B. ECASS
C. J-ACT
D. IST III
A

D. IST III (p. 90)

35
Q 
Patients with spontaneous ICH within 6 h were randomized to receive intensive treatment to lower SBP to <140 mmHg vs <180 mmHg using drugs of physician's choice for 1 week
A. IST
B. IST III
C. INTERACT II
D. ATACH II
A

C. INTERACT II (p. 93)

36
Q 
Patients with acute ICH randomized to receive intensive treatment to lower SBP < 140 mmHg vs <180 mmHg within 24 h of randomization using IV nicardipine
A. IST
B. IST III
C. INTERACT II
D. ATACH II
A

D. ATACH II (p. 93)

37
Q 
Inclusion criteria: ages 18-60
Time to treatment: 36h
Primary outcome: death at 30 days, MRS <4 at 6 months
A. DESTINY
B. DESTINY II
C. DECIMAL
D. HAMLET
E. HEMMI
A

A. DESTINY (p. 100)

38
Q 
Inclusion criteria: NIHSS > 18-20
Time to treatment: 24h
Primary outcome: MRS <4 at 6 months
A. DESTINY
B. DESTINY II
C. DECIMAL
D. HAMLET
E. HEMMI
A

C. DECIMAL (p. 100)

39
Q 
Inclusion criteria: ages 18-55
Time to treatment: 96h
Primary outcome: MRS <4 at 12 months
A. DESTINY
B. DESTINY II
C. DECIMAL
D. HAMLET
E. HEMMI
A

D. HAMLET (p. 100)

40
Q 
Inclusion criteria: acute unilateral MCA ischemia
Time to treatment: 72h
Primary outcome: MRS 0-3; death
A. DESTINY
B. DESTINY II
C. DECIMAL
D. HAMLET
E. HEMMI
A

E. HEMMI (p. 100)

41
Q 
Inclusion criteria: ages 18-65; GCS 10-14 (right), 5-9 (left)
Time to treatment: 48h
Primary outcome: MRS at 6 months
A. DESTINY
B. DESTINY II
C. DECIMAL
D. HAMLET
E. HEMMI
A

B. DESTINY II (p. 100)

42
Q 
This study showed a 23% odds reduction in the composite outcome of MI, stroke, or vascular death among patients with symptomatic atherosclerosis on asa ASA 50-1500 mg/day
A. ATC
B. CATS
C. TASS
D. CAPRIE
E. SPS 3
A

A. ATC (p. 104)

43
Q 
Ticlopidine reduced the risk of composite outcome of MI, stroke, and vascular death by 30% compared to placebo
A. ATC
B. CATS
C. TASS
D. CAPRIE
E. SPS 3
A

B. CATS (p. 105)

44
Q 
Ticlopidine reduced the risk of stroke or death at 3 years by 12% relative to ASA
A. ATC
B. CATS
C. TASS
D. CAPRIE
E. SPS 3
A

C. TASS (p. 105)

45
Q 
Clopidorel reduced the combination endpoint of ischemic stroke, MI, or ascular death by 8.7% relative to ASA
A. CAPRIE
B. MATCH
C. CHARISMA
D. SPS 3
A

A. CAPRIE (p. 105)

46
Q 
There was no significant difference between clopidogrel + ASA vs clopidogrel monotherapy in the combined endpoint of ischemic stroke, MI, vascular death, or rehospitalization at 18 months 
A. CAPRIE
B. MATCH
C. CHARISMA
D. SPS 3
A

B. MATCH (p. 105)

47
Q 
Clopidogrel + ASA was not significantly more effective than ASA alone in reducing rate of MI, stroke, or vascular death among patients with clinically evident cardiovascular disease or those with multiple risk factors
A. CAPRIE
B. MATCH
C. CHARISMA
D. SPS 3
A

C. CHARISMA (p. 105)

48
Q 
The rate of recurrent stroke was not significantly different between clopidogrel + ASA vs ASA among patients with recent symptomatic lacunar infarction
A. CAPRIE
B. MATCH
C. CHARISMA
D. SPS 3
A

D. SPS 3 (p. 105)

49
Q 
Cilostazol reduced the risk of recurrent ischemic stroke by 41.7% compared to placebo
A. CSPS
B. CSPS2
C. TOSS 1
D. TOSS 2
A

A. CSPS (p. 106)

50
Q 
Progression of symptomatic intracranial stenosis by MRA was significantly lower with cilostazol + ASA compared with ASA alone
A. CSPS
B. CSPS2
C. TOSS 1
D. TOSS 2
A

C. TOSS 1 (p. 106)

51
Q 
A non-inferiority study comparing cilostazol and ASA in terms of annual occurrence of stroke
A. CSPS
B. CSPS2
C. TOSS 1
D. TOSS 2
A

B. CSPS 2 (p. 106)

52
Q 
No significant difference in rate of progression of ICAS by MRA between cilostazol + ASA vs clopidogrel + ASA
A. CSPS
B. CSPS2
C. TOSS 1
D. TOSS 2
A

D. TOSS 2 (p. 106)

53
Q 
ASA + dipyridamole reduced the risk of stroke and death by 33% compared to placebo
A. ESPS 1
B. ESPS 2
C. ESPRIT
D. PROFESS
A

A. ESPS 1 (p. 106)

54
Q 
Composite outcome of stroke, MI, and death were reduced by 20% with ASA + dipyridamole vs ASA alone
A. ESPS 1
B. ESPS 2
C. ESPRIT
D. PROFESS
A

C. ESPRIT (p. 107)

55
Q 
Stroke reduction compared to placebo were: ASA 18%, dipyridamole 16%, ASA + dipyridamole 37.8%
A. ESPS 1
B. ESPS 2
C. ESPRIT
D. PROFESS
A

B. ESPS 2 (p. 106)

56
Q 
Similar rates of recurrent ischemic stroke between ASA-DP group vs clopidogrel with more major hemorrhagic events with ASA-DP
A. ESPS 1
B. ESPS 2
C. ESPRIT
D. PROFESS
A

D. PROFESS (p. 107)

57
Q 
Similar efficacy between triflusal and ASA groups in combined endpoint of stroke, MI, and vascular death among patients with recent TIA or ischemic stroke with median follow-up of 30 months
A. TOSS 1
B. TOSS 2
C. TACIP
D. TAPIRSS
A

C. TACIP (p. 107)

58
Q 
No significant difference in the combined endpoint of stroke, MI, and vascular death and major bleeding between ASA and triflusal groups among patients with TIA or ischemic stroke with median follow-up of 28 months
A. TOSS 1
B. TOSS 2
C. TACIP
D. TAPIRSS
A

D. TAPIRSS (p. 107)

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