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Acute stroke — DIPIMC MCQ

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ModerateMedical EmergenciesAcute strokeDIPIMCDipIMC

A 70-year-old developed sudden right-sided facial droop, arm weakness and slurred speech 90 minutes ago. Capillary glucose is normal. Blood pressure is 178/96 mmHg and she is otherwise stable. What is the most appropriate management?

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

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Correct answer: E — Recognise acute stroke and transfer rapidly to a hyperacute stroke unit

A FAST-positive presentation within the reperfusion window should prompt rapid transfer to a hyperacute stroke unit with a pre-alert, and the blood pressure should not be lowered acutely in the pre-hospital phase, as this may worsen cerebral perfusion. Aspirin is withheld until haemorrhage is excluded by imaging. The nearest emergency department may not provide hyperacute stroke care. Pearl: time is brain, so minimising the onset-to-scan interval is the priority.

Reference: JRCALC Clinical Guidelines