A 70-year-old man presents to the emergency department with sudden onset right-sided weakness and expressive aphasia. Symptoms began 2 hours ago. His blood pressure is 160/95 mmHg. A non-contrast head CT shows no evidence of intracranial hemorrhage. Which of the following is the most appropriate immediate next step in management?

The correct answer to the question "A 70-year-old man presents to the emergency department with sudden onset right-sided weakness and expressive aphasia. Symptoms began 2 hours ago. His blood pressure is 160/95 mmHg. A non-contrast head CT shows no evidence of intracranial hemorrhage. Which of the following is the most appropriate immediate next step in management?" is Option B: Administer intravenous alteplase.

The other options — A) Administer aspirin 325 mg orally, C) Start a heparin infusion, D) Schedule for carotid endarterectomy — are incorrect for this USMLE Exam Prep question. As explained above: For acute ischemic stroke within the therapeutic window (typically 4.5 hours from symptom onset) and no contraindications on non-contrast CT, intravenous alteplase (tPA) is the first-line treatment t…