Question

A 68-year-old with sudden right hemiparesis arrives 2.5 hours after onset. BP is 196/112 mm Hg, CT head shows no hemorrhage. Weight 80 kg. Next best step?

Accepted Answer

Lower BP to <185/110 mm Hg and give IV alteplase 0.9 mg/kg (max 90 mg)

Answer

Administer aspirin 325 mg and admit for monitoring

Answer

Begin full-dose heparin infusion

Answer

Delay thrombolysis until MRI confirms infarct

Answer

Give tenecteplase 1 mg/kg IV

Practice question

A 68-year-old with sudden right hemiparesis arrives 2.5 hours after onset. BP is 196/112 mm Hg, CT head shows no hemorrhage. Weight 80 kg. Next best step?