#january2020mccqe1
A 74-year-old man is brought to the emergency department by ambulance 1 hour after he had an acute witnessed onset of aphasia and right hemiparesis. He has a history of hypertension. His current medications are hydrochlorothiazide and metoprolol. On physical examination, blood pressure is 178/94 mm Hg and pulse rate is 80/min and regular. Neurologic examination confirms nonfluent aphasia, a right pronator drift, a right leg drift, and an extensor plantar response on the right.
An electrocardiogram obtained on the patient's arrival at the emergency department documents sinus rhythm. A CT scan of the head obtained within 1 hour of his arrival reveals early ischemic changes. Which of the following is the best treatment?
(A) Aspirin
(B) Continuous intravenous heparin
(C) Intravenous labetalol
(D) Intravenous recombinant tissue plasminogen activator
A 74-year-old man is brought to the emergency department by ambulance 1 hour after he had an acute witnessed onset of aphasia and right hemiparesis. He has a history of hypertension. His current medications are hydrochlorothiazide and metoprolol. On physical examination, blood pressure is 178/94 mm Hg and pulse rate is 80/min and regular. Neurologic examination confirms nonfluent aphasia, a right pronator drift, a right leg drift, and an extensor plantar response on the right.
An electrocardiogram obtained on the patient's arrival at the emergency department documents sinus rhythm. A CT scan of the head obtained within 1 hour of his arrival reveals early ischemic changes. Which of the following is the best treatment?
(A) Aspirin
(B) Continuous intravenous heparin
(C) Intravenous labetalol
(D) Intravenous recombinant tissue plasminogen activator
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