A 63-year-old with acute ischemic stroke presents 90 minutes after onset, BP 198/112 mmHg, NIHSS 8, no hemorrhage on CT. What is the next best step to...

Question

A 63-year-old with acute ischemic stroke presents 90 minutes after onset, BP 198/112 mmHg, NIHSS 8, no hemorrhage on CT. What is the next best step to enable thrombolysis?

Accepted Answer

Lower BP to ≤185/110 mmHg (e.g., IV labetalol) then give alteplase

Answer

Proceed with alteplase immediately

Answer

Administer aspirin 325 mg now and defer thrombolysis

Answer

Intubate before thrombolysis to protect airway

Answer

Give IV fluids and recheck BP in 2 hours

Acute Ischemic Stroke-tPA Eligibility — USMLE Step 2 CK MCQ

A 63-year-old with acute ischemic stroke presents 90 minutes after onset, BP 198/112 mmHg, NIHSS 8, no hemorrhage on CT. What is the next best step to enable thrombolysis?