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Status epilepticus — RCPSC EM MCQ

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HardNeurological emergenciesStatus epilepticusRCPSC EM

A patient with non-disabling ischemic stroke is not eligible for thrombolysis or EVT. BP is 214/112 mmHg without aortic dissection, ACS, pulmonary edema or hypertensive encephalopathy. What is the BP strategy?

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

Reveal the answer and explanation

Correct answer: E — Avoid acute BP reduction and monitor for another emergency indication

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E

D is correct: moderate elevation up to about 220 systolic is usually left untreated when reperfusion is not planned, absent another emergency. E and A risk reducing ischemic perfusion. B causes unpredictable rapid reduction. C creates an unnecessary antiplatelet delay after hemorrhage is excluded.

Reference: Canadian Stroke Best Practices, Emergency Department Evaluation and Management: https://www.strokebestpractices.ca/recommendations/acute-stroke-management/emergency-department-evaluation-and-management