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American Clinical Rotations & USCE for IMG / FMG Medical Doctors and Students
A 55-year-old man with a history of hypertension and diabetes presents with sudden-onset right-sided weakness and facial droop. A non-contrast head CT shows a hyperdense left middle cerebral artery. Which of the following is the most appropriate next step in management?
Correct Answer: B - The hyperdense middle cerebral artery on non-contrast CT is indicative of acute ischemic stroke. Intravenous alteplase is the first-line treatment for eligible patients within 4.5 hours of symptom onset.
A. Aspirin
Aspirin: Aspirin is used for secondary prevention but is not the first-line treatment for acute ischemic stroke.
C. Clopidogrel
Clopidogrel: Clopidogrel is not the first-line treatment for acute ischemic stroke. Intravenous alteplase is preferred.
D. Warfarin
Warfarin: Warfarin is not used in the acute phase of ischemic stroke. It is used for long-term prevention in certain cases.
E. Carotid endarterectomy
Carotid endarterectomy: Carotid endarterectomy is not indicated in the acute management of ischemic stroke.