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Acute stroke — DIPIMC MCQ

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ModerateMedical EmergenciesAcute strokeDIPIMCDipIMC

A patient develops sudden right-sided weakness and expressive dysphasia. Symptom onset was 90 minutes ago and he takes metformin for diabetes.

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

Reveal the answer and explanation

Correct answer: B — Check the capillary blood glucose to exclude hypoglycaemia, then pre-alert a hyperacute stroke unit

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

The first step in a suspected stroke is to check capillary blood glucose, because hypoglycaemia is a common and fully reversible stroke mimic, after which the patient should be conveyed rapidly with a pre-alert to a hyperacute stroke unit. Aspirin (A) is given only after haemorrhage is excluded by imaging, and never pre-hospital. Always exclude hypoglycaemia, then move fast to definitive imaging and reperfusion.

Reference: NICE stroke guidance; JRCALC