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Acute ischaemic stroke — MCCQE Part 1 MCQ

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ModerateWeaknessAcute ischaemic strokeMCCQE Part 1

A 72-year-old woman develops sudden right-sided weakness and aphasia 75 minutes before arrival. Glucose is normal, blood pressure is 178/92 mmHg and non-contrast CT head shows no haemorrhage. Which of the following is the most appropriate next step?

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Correct answer: A — Activate acute stroke protocol and assess eligibility for intravenous thrombolysis and endovascular therapy

This is an acute disabling ischaemic stroke within the treatment window, requiring code stroke assessment for thrombolysis and possible EVT. Aspirin is used after haemorrhage exclusion and when reperfusion decisions are addressed; warfarin is not immediate acute therapy. Symptom improvement does not remove the need for urgent evaluation because salvageable brain may remain.

Reference: Canadian Stroke Best Practice Recommendations, Acute Stroke Management