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January 8th, 2024Hi there!
You’re looking at a multiple-choice question from QBank Prepper (the newest of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.
A 72-year-old man is brought to the emergency department after complaining of sudden onset of left-sided weakness and slurred speech 4 hours ago. He has a past medical history of poorly controlled hypertension and type 2 diabetes mellitus. His temperature is 37.3ºC (99.1ºF), pulse is 82/min, respiration is 16/min, and blood pressure is 192/102 mmHg. His O2 saturation is 98% on room air. He is awake and alert. He has a left central facial palsy, a left-sided hemiparesis grade 2/5, with a left-sided Babisnki sign. His NIH Stroke Scale score is 11 (000122202001010). His blood glucose is 180 mg/dL. ECG shows normal sinus rhythm. A CT scan shows a large right-hemispheric infarction without evidence of edema (ASPECTS 4). The patient is admitted to the hospital's stroke unit. Which of the following is the most appropriate next step in his management?