QuestionSBA
QuestionChoice
In an acute ischaemic stroke setting, 300mg of aspirin is used rather than 1g. Furthermore, the provision of aspirin must be delayed until haemorrhagic stroke has been ruled out with brain imaging.
10000333
c
Aspirin 1g
QuestionChoice
NICE stroke and TIA guidelines state that a non-contrast CT head scan should be performed immediately for anyone suspected of an acute stroke who meets the following criteria:

* Indications for thrombolysis/thrombectomy
* On anticoagulant treatment
* Known bleeding tendency
* Depressed consciousness
* Unexplained progressive or fluctuant symptoms
* Papilloedema, neck stiffness or fever
* Severe headache at symptom onset

Brain imaging must be performed before the provision of aspirin as haemorrhagic stroke has to be ruled out.
10000331
a
Non-contrast CT head
QuestionChoice
Although aspirin forms an important part of stroke management, it is vital to rule out the presence of a haemorrhagic stroke before the provision of antiplatelet therapy. NICE and Royal College of Physician guidelines recommend the use of a non-contrast CT-head scan immediately to rule out bleeding before aspirin is prescribed.
10000332
b
Aspirin 300mg
QuestionChoice
Although this patient would fall under the time limit for thrombolysis, it is not the first step in the acute stroke management scenario. A non-contrast CT scan must be performed as soon as possible to rule out haemorrhage. After a diagnosis of haemorrhagic stroke has been ruled out and ischaemic stroke confirmed, other management options such as thrombolysis or thrombectomy can be considered and aspirin 300mg can be started.
10000335
e
Thrombolysis
QuestionChoice
Although brain imaging is vital to perform immediately to rule out haemorrhagic stroke, a non-contrast CT scan is performed and not an MRI. In the stroke management setting, time is vital and so the speed of a non-contrast CT makes it preferable to the slower MRI. CT scan also retains high sensitivity for haemorrhagic stroke so is a reliable rule-out tool.
10000334
d
MRI head
Concept
Chapter
2693
3744
Haemorrhagic Stroke
Topic
141
Neurology
12613
A 72-year-old female presents to the emergency department with a 1-hour history of sudden onset weakness of her right arm and leg, as well as facial drooping. On examination, you identify a right hemiparesis with sensory function intact. You suspect a diagnosis of stroke.

Which of the following is the most appropriate next step?
a