Question

A 72-year-old presents within 90 minutes of onset of right-sided weakness. BP is 210/120 mm Hg, glucose 110 mg/dL, CT head shows no bleed. Next best step to enable IV alteplase?

Accepted Answer

Lower BP to <185/110 mm Hg (e.g., IV labetalol) then give alteplase

Answer

Start aspirin 325 mg and defer thrombolysis

Answer

Give alteplase without BP control to avoid delay

Answer

Wait for MRI confirmation

Answer

Start heparin infusion

Practice question

A 72-year-old presents within 90 minutes of onset of right-sided weakness. BP is 210/120 mm Hg, glucose 110 mg/dL, CT head shows no bleed. Next best step to enable IV alteplase?