skip to main content

High-Risk TIA – Urgent Assessment — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardCerebrovascular DiseaseHigh-Risk TIA – Urgent AssessmentSCE Neurology

A 54-year-old develops 20 minutes of aphasia and right-hand weakness that have fully resolved. Examination and capillary glucose are now normal. There is no anticoagulant use or aspirin contraindication. Which initial pathway best follows NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Give aspirin 300 mg, refer for specialist review within 24 hours, and do not use ABCD² or routine CT for triage

NICE advises immediate aspirin 300 mg, unless contraindicated, and immediate referral of every person with a suspected TIA for specialist assessment and investigation within 24 hours. ABCD² should not determine urgency because apparently low scores can coexist with important mechanisms such as carotid stenosis or atrial fibrillation. CT brain is not routinely offered for suspected TIA unless it could identify an alternative diagnosis. MRI may be considered after specialist assessment and, if performed, should be done on the same day. Empirical anticoagulation without establishing an indication is unsafe.

Reference: NICE NG128, stroke and transient ischaemic attack in over 16s: https://www.nice.org.uk/guidance/ng128/chapter/recommendations