USMLE Forum Archives - USMLE Step 2 CK - neuro question
neuro question
alaamn - 11-05-09 10:48
A 64-year-old African-American woman with a history of hypertension and a recent myocardial infarction is brought to the ED by ambulance after developing paralysis of one side of her body and having trouble talking. Her vital signs are stable, but her blood pressure is 190/90 mm Hg. Brain imaging identifies a large ischemic area in the right anterior and middle cerebral artery distribution. Bedside carotid duplex shows complete occlusion of the right internal carotid just distal to the bifurcation. Laboratory values show a platelet count of 250,000/mm3, blood glucose of 110 mg/dl, and normal coagulation times. She has no known drug allergies and is fecal occult blood test negative.
Administering which of the following drugs would constitute emergent, evidence-based therapy in this patient?
alaamn - 11-05-09 10:48
A 64-year-old African-American woman with a history of hypertension and a recent myocardial infarction is brought to the ED by ambulance after developing paralysis of one side of her body and having trouble talking. Her vital signs are stable, but her blood pressure is 190/90 mm Hg. Brain imaging identifies a large ischemic area in the right anterior and middle cerebral artery distribution. Bedside carotid duplex shows complete occlusion of the right internal carotid just distal to the bifurcation. Laboratory values show a platelet count of 250,000/mm3, blood glucose of 110 mg/dl, and normal coagulation times. She has no known drug allergies and is fecal occult blood test negative.
Administering which of the following drugs would constitute emergent, evidence-based therapy in this patient?
The correct answer and explanation will be available after you answer.
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#5
Re: neuro question conym5 - 11-17-09 21:51 My answer is: a.
it looks like stroke.. aspirine wiuld be the 1st line therapy,,,
Intravenous nitroprusside...when blood pressure is more than 210/100,,,
Tissue plasminogen activator...when pt comes with in 2hrs after symptoms
#15
Re: neuro question conym5 - 12-23-09 08:28 aspirin therapy has already been shown to reduce the long-term risk of a second stroke in survivors of ischemic strokes -- caused by clots blocking blood flow to the brain .
#31
Re: neuro question ammulufy - 03-14-10 21:52 My answer is: c.
In this there is more concern abt d occlusion revealed by the carotid duplex whch needs to be attended to decelerate the progression of ischaemia to an infarct in the brain......hence a potent vasodilator like iv Nitroprusside is most indicated than any other options.....ptnt is not required to b put on any kind of anticoagulant therapy......as there are no signs of thrombus frmn revealed by carotid duplex.
#40
Re: neuro question mtniharika - 04-29-10 09:52 My answer is: d.
o be effective in ischemic stroke, tPA must be administered within the first three hours of the event to be given intravenously, or within six hours to be administered through an arterial catheter directly to the site of occlusion
#61
Re: neuro question babbu5508 - 03-31-11 18:58 Aspirin has been shown to reduce morbidity and mortality when administered within 48 hrs of a myocardial infarction........
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