Cerebrovascular Disease USMLE Step 1 Practice Question
A 67-year-old man with hypertension and atrial fibrillation presents with acute onset left facial droop and arm weakness. Vital signs: BP 158/92 mmHg, HR 102 bpm (irregular), RR 16, SpO2 98% on room air. CT head shows no hemorrhage. Labs reveal INR 1.2. He denies recent headache or vision changes. Symptom onset was 2 hours ago. Which of the following is the most appropriate next step in management?
Answer choices
- AStart aspirin and observe for 24 hours
- BBegin warfarin therapy immediately
- CPerform immediate mechanical thrombectomy
- DAdminister intravenous alteplaseCorrect answer
- EObtain perfusion imaging before any intervention
- FInitiate immediate anticoagulation with intravenous heparin
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