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Transient ischaemic attack — SCE Acute Medicine MCQ

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ModerateAcute Neurological PresentationsTransient ischaemic attackSCE Acute Medicine

A 42-year-old woman 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 resolved focal symptoms lasting 20 minutes with normal examination. 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: A — Give aspirin 300 mg and arrange specialist TIA assessment within 24 hours

The key discriminator is that resolved focal symptoms lasting 20 minutes with normal examination, which makes Give aspirin 300 mg and arrange specialist TIA assessment within 24 hours the single best answer. Give analgesia and antiemetic therapy is less appropriate because it does not address the dominant acute risk in the vignette; Give controlled oxygen and senior review would fit a different presentation or later stage of care. Start anticoagulation after assessing bleeding risk and Provide supportive care and close monitoring 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