A 74-year-old with acute ischemic stroke (onset 2 hours ago) has BP 182/104 mmHg, glucose 118 mg/dL, no hemorrhage on CT, and no contraindications. Wh...

Question

A 74-year-old with acute ischemic stroke (onset 2 hours ago) has BP 182/104 mmHg, glucose 118 mg/dL, no hemorrhage on CT, and no contraindications. What should be done now?

Accepted Answer

Administer IV alteplase 0.9 mg/kg (max 90 mg) after lowering BP to

Answer

Start full-dose IV heparin infusion immediately

Answer

Delay reperfusion because window is 3-4.5 h only for patients

Answer

Give aspirin now and reassess in 24 h

Answer

Transfer for thrombectomy only; alteplase is contraindicated within 3 h

us-abem MCQ (SBA): Acute Ischemic Stroke

A 74-year-old with acute ischemic stroke (onset 2 hours ago) has BP 182/104 mmHg, glucose 118 mg/dL, no hemorrhage on CT, and no contraindications. What should be done now?