Emergency Physicians Monthly has teamed up with the board prep pros at Rosh Review to bring you a mini board review, so that you can test yourself on a regular basis and track your progress. The following is the test – and answers – from the June edition of Emergency Physicians Monthly. Questions about the test? Talk back on Twitter @epmonthly.
QUESTION: According to the most recent American Heart Association (AHA)/American Stroke Association (ASA) Stroke Council guidelines, which of the following patients is a candidate for the administration of tissue plasminogen activator (tPA)?
A. 61-year-old man with a left-sided facial droop and left-sided paresis that began 45 minutes prior to arrival, who has a history of cirrhosis, and his INR is 2.1
B. 67-year-old woman with decreased mentation and right-sided facial droop that began 60 minutes prior to arrival and has a blood glucose level of 45 mg/dL.
C. 69-year-old man with a history of an intracranial hemorrhage 5 years ago, who presents with 60 minutes of right-sided facial droop, aphasia, and left-sided paresis.
D. 75-year-old man diagnosed with a subdural hematoma 2 months ago after a fall and now presents with 30 minutes of aphasia and right-sided paresis
E. 75-year-old woman with dysarthria, right-sided motor and sensory deficits that began 2 hours prior to arrival, and has a blood pressure of 175/90 mm Hg