skip to main content

Acute ischaemic stroke within thrombolysis window — SCE Acute Medicine MCQ

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

EasyAcute Neurological PresentationsAcute ischaemic stroke within thrombolysis windowSCE Acute Medicine

A 58-year-old man presents with acute neurological symptoms. Relevant history includes vascular, infectious or neuromuscular risk factors. On assessment, neurological examination shows focal or global dysfunction. Investigations show disabling stroke within 70 minutes and CT excludes haemorrhage. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: D — Give intravenous thrombolysis after stroke-team assessment

The key discriminator is that disabling stroke within 70 minutes and CT excludes haemorrhage, which makes Give intravenous thrombolysis after stroke-team assessment the single best answer. Provide supportive care and close monitoring is less appropriate because it does not address the dominant acute risk in the vignette; Optimise chronic medication and discharge would fit a different presentation or later stage of care. Give analgesia and antiemetic therapy and Call critical care for escalation are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG128