Your exam reveals left sided arm and leg hemiparesis.
What bedside test is imperative to evaluate for easily reversible cause of symptoms?
Blood sugar
Visual acuity
Reflexes
Blood pressure
Blood sugar should be checked on all patients with stroke symptoms, as hypoglycemia is a stroke mimic. Administration of glucose in a hypoglycemic patient could rapidly reverse symptoms and spare patient risk of any thrombolytic.
The expectation of time to evaluation, time to CT scan, time to CT read, and time to diagnosis in an acute ischemic stroke is?
15 minutes to assess, 25 minutes to CT scan, 60 minutes to CT read, 80 minutes to diagnosis
10 minutes to assess, 25 minutes to CT scan, 45 minutes to CT read, 60 minutes to diagnosis
10 minutes to assess, 30 minutes to CT scan, 45 minutes to CT read, 90 minutes to diagnosis
25 minutes to assess, 45 minutes to CT scan, 60 minutes to CT read, 70 minutes to diagnosis
10 minutes to assess, 25 minutes to CT scan, 45 minutes CT read, and 60 minutes to diagnosis.
You are concerned for ischemic stroke and are considering administration of TPA.
Which of the following are absolute contraindications for administration of tpa?
Minor, resolving symptoms.
Symptom onset within the last 3 hours
Stroke in the last 3 months
Platelet count less than 150,000
Absolute contraindications to tpa include:
Intracranial hemorrhage on CT
SAH
Neurosurgery, stroke, or head trauma in the last 3 months
Uncontrolled hypertension: >/=. 185/110
History of intracranial hemorrhage, AVM, or neoplasm
Active internal bleeding
Platelet count <100,000 or INR > 1.7 or use of anticoagulation
Hypoglycemia (blood sugar <50)
Large stroke: NIH >. Or multi lobar stroke on CT
