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Which of the following is not one of the absolute exclusionary criteria for tissue plasminogen activator (tPA)?
An 18-year-old male with a history of IV drug use was found unresponsive on a park bench by police. He was intubated by EMS and sent directly to the emergency room. The patient is comatose on examination. CT scan of the head is shown below. What is the likely diagnosis?
A 39-year-old male presents with right-sided weakness and aphasia. NIHSS is 22 on physical exam. He was last known well 2.5 hours prior. The past medical history does not reveal any contraindications to tPA. A CT head is done and shows a hyperdense left MCA sign. The tPA is mixed by the nursing staff while you consent his wife for its administration. When you return to the bedside his aphasia has improved but his NIHSS is still 13. The blood pressure is 189/105 and the glucose is 225. What is the most appropriate next step?
A 75-year-old man with a past medical history of hypertension, hyperlipidemia, and diabetes presents with acute onset right arm weakness and speech problems. He can speak fluently and his comprehension is intact. However, he is unable to repeat even simple sentences. Reading and writing are preserved. Which of the following is an accurate description of his speech dysfunction?
A 26-year-old female presents to the hospital following a sudden onset headache and decreased responsiveness. A CT Head is obtained (left) followed by a cerebral angiogram (right). Which of the following is the most likely cause of the patient’s symptoms?
What is the mechanism of action of apixaban?
The brain MRI (susceptibility-weighted imaging) shown below is most likely associated with which of the following conditions?
A 37-year-old man with a history of hypertension presents to the emergency department with a one-day history of difficulty walking. On examination, he has right leg paresis and hyperreflexia with a right-sided Babinski response. His non-contrast axial CT scan is shown below. Which of the following is the most likely etiology of this patient’s symptoms?
Which of the following findings is depicted in the vessel imaging shown?
How long ago did the ischemic injury seen on this neuronal tissue micropathology slide occur?
A patient with a history of hypertension and provoked seizures secondary to posterior reversible encephalopathy syndrome (PRES) has come to your clinic for a 6-month follow-up after her associated hospitalization. It was found that abrupt discontinuation of her hypertensive medications due to medication noncompliance was the cause of the PRES. She was started on the anti-seizure medication (ASM) levetiracetam at the time of her PRES and has had no seizures since being discharged. She asks you about the risk of future seizures. What is the most appropriate response?
The MR angiogram shown below demonstrates which of the following?
A 74-year-old female presents to the ED for trouble with swallowing and balance. On physical examination, she is unable to speak clearly and has no gag reflex. Pain and temperature sensation on the right side of her body and the left side of her face is decreased. She is unable to walk unassisted and has dysmetria on the finger-to-nose exam. MRI of the brain shows an ischemic stroke. The artery that is affected most commonly branches off of which of the following?
A 26-year-old female with a past medical history of pulmonary embolism presents with seizures and left-sided weakness. She had been complaining about a headache for the past week. An MR venogram is shown below. Which of the following is the next best step in management?