Cerebrovascular Disease USMLE Step 1 Practice Question
A 62-year-old man with hypertension and diabetes presents with acute onset right-sided weakness and facial droop while having breakfast. His wife activates emergency services immediately, and he arrives at the ED within 45 minutes of symptom onset. Neuroimaging shows no evidence of hemorrhage. Which of the following is the most appropriate next step in management?
Answer choices
- AAdminister heparin anticoagulation immediately
- BObtain an MRI of the brain before any intervention
- CStart aspirin 325 mg orally and admit for observation
- DPerform immediate carotid ultrasound to assess for stenosis
- EAdminister intravenous alteplase (tissue plasminogen activator)Correct answer
- FAdminister subcutaneous enoxaparin and defer intervention until repeat imaging at 24 hours
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