Question

A 60-year-old woman with acute onset right-sided weakness 90 minutes ago, BP 182/104 mmHg, noncontrast CT shows no bleed. Next best step to enable IV alteplase?

Accepted Answer

Lower BP to <185/110 mmHg and administer IV alteplase within 4.5 hours of onset

Answer

Delay therapy until MRI completed

Answer

Start full-dose heparin infusion

Answer

Allow permissive hypertension to 220/120 and avoid thrombolysis

Answer

Administer aspirin now and avoid tPA

Practice question

A 60-year-old woman with acute onset right-sided weakness 90 minutes ago, BP 182/104 mmHg, noncontrast CT shows no bleed. Next best step to enable IV alteplase?