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Posterior circulation stroke — DipIMC MCQ

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HardMedical EmergenciesPosterior circulation strokeDipIMC

A 66-year-old woman has sudden vertigo, vomiting, ataxia and slurred speech. FAST is negative, glucose is normal and symptoms began 90 minutes ago. What is the most appropriate transport decision?

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

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Correct answer: E — Pre-alert and transport through the acute stroke pathway

Posterior circulation stroke may present with vertigo, ataxia, vomiting and dysarthria, and FAST can be negative. The time window makes stroke pathway activation important. Symptomatic improvement or antiemetic response does not exclude stroke. The pearl is that BE-FAST features such as balance and eye symptoms matter in pre-hospital stroke recognition.

Reference: JRCALC Guidelines 2025; NICE Stroke and TIA NG128