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Stroke with large vessel occlusion features — DipIMC MCQ

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HardMedical EmergenciesStroke with large vessel occlusion featuresDipIMC

A 71-year-old woman is found 50 minutes after sudden aphasia and right hemiplegia. Blood glucose is 6.1 mmol/L, FAST is positive, blood pressure is 178/96 mmHg and the thrombectomy-capable hyperacute stroke centre is 35 minutes away; a smaller stroke unit is 12 minutes away. What is the most appropriate transport decision?

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

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Correct answer: D — Convey directly to the thrombectomy-capable hyperacute stroke centre according to local pathway

Severe cortical stroke features within a thrombectomy window favour direct conveyance to an appropriate hyperacute pathway where local protocols support bypass. Aspirin is deferred until intracranial haemorrhage has been excluded. Pre-hospital blood pressure lowering is not routine unless directed by specialist pathway.

Reference: JRCALC Guidelines; NICE stroke and TIA guidance