🏥 USMLE Exam Prep

A 70-year-old man with a history of atrial fibrillation, not on anticoagulation, presents to the emergency department with sudden-onset left-sided weakness and facial droop. Symptoms began 2 hours ago. Non-contrast CT head is unremarkable for hemorrhage. His NIHSS score is 12. What is the most appropriate next step in management?

A Administer aspirin
B Initiate intravenous tissue plasminogen activator (tPA)
C Start subcutaneous heparin
D Schedule for carotid endarterectomy

✓ Correct Answer: Option B

This patient presents with an acute ischemic stroke within the therapeutic window (within 4.5 hours of symptom onset) and no contraindications on non-contrast CT. Intravenous tPA is indicated to restore blood flow.

Related USMLE Exam Prep Questions