🏥 USMLE Exam Prep

A 70-year-old female presents to the emergency department with sudden onset right-sided weakness and aphasia. Her symptoms started 2 hours ago. Her blood pressure is 160/90 mmHg, and she has no history of recent trauma or bleeding disorders. A non-contrast head CT scan is negative for hemorrhage. Which of the following is the most appropriate next step in management?

A Administer aspirin and clopidogrel immediately.
B Initiate intravenous tissue plasminogen activator (tPA).
C Order a cerebral angiogram to identify the occlusion.
D Administer intravenous labetalol to lower blood pressure below 140/90 mmHg.

✓ Correct Answer: Option B

Given the sudden onset of symptoms within the tPA window (within 4.5 hours), right-sided weakness, aphasia, and absence of hemorrhage on CT, tPA is indicated for acute ischemic stroke.

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