🏥 USMLE Exam Prep

A 72-year-old male presents to the ED with sudden-onset left-sided weakness and slurred speech that resolved completely within 30 minutes. His medical history includes hypertension and hyperlipidemia. A non-contrast head CT scan is negative for acute hemorrhage or infarct. What is the most appropriate next diagnostic step?

A Initiate aspirin and discharge home
B Obtain a carotid duplex ultrasound
C Perform a lumbar puncture
D Schedule an immediate MRI of the brain with diffusion-weighted imaging

✓ Correct Answer: Option D

For a transient ischemic attack (TIA) with a negative non-contrast CT, an MRI of the brain with diffusion-weighted imaging (DWI) is the most sensitive test to detect acute infarcts and should be performed urgently to guide further management.

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