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Stroke thrombolysis mimic — DGM MCQ

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HardStroke and rehabilitationStroke thrombolysis mimicDGM

A 75-year-old woman presents with sudden slurred speech and unilateral weakness. Symptoms began 70 minutes ago. Capillary glucose is 2.1 mmol/L and she takes insulin. Current medicines include insulin and ramipril. What is the most appropriate assessment?

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Correct answer: B — Treat hypoglycaemia and reassess neurological deficits

Hypoglycaemia can mimic stroke and should be corrected urgently before reassessing persistent deficits. Thrombolysis without correction is unsafe, discharge may miss true stroke after correction, anticoagulation is not immediate, and memory clinic is irrelevant. Glucose measurement is an essential early test in suspected stroke.

Reference: NICE stroke guidance