Posterior circulation ischaemic stroke — SCE Acute Medicine MCQ

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HardAcute Neurological PresentationsPosterior circulation ischaemic strokeSCE Acute Medicine

A 55-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 vertigo with dysarthria, limb ataxia and normal early CT. What is the most likely diagnosis?

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Correct answer: E — Posterior circulation ischaemic stroke

The key discriminator is that vertigo with dysarthria, limb ataxia and normal early CT, which makes Posterior circulation ischaemic stroke the single best answer. Acute pancreatitis is less appropriate because it does not address the dominant acute risk in the vignette; Bacterial meningitis would fit a different presentation or later stage of care. Acute coronary syndrome and Acute kidney injury 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