58-year-old woman on Rivaroxaban for 2 weeks (last time she took it was before six hours)for atrial fibrillation, NIHAS score was 19, presented to the er with 1 hour left side hemiplegia and aphasia, Ct normal, and no reverse agent in hospital. What would be the most appropriate step?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Hold IV tPA and give mechanical thrombectomy if eligible
She has an acute ischaemic stroke within the window, but she took rivaroxaban 6 hours ago and no reversal agent is available. Recent anticoagulant use is a contraindication to IV tPA, so hold tPA and go for mechanical thrombectomy if she has a large-vessel occlusion. Thrombectomy is offered whether or not a thrombolytic has been given.
- Immediate tPA (A) ignores the contraindication.
- PCC (C) is listed in the sources for reversing DOACs in intracerebral haemorrhage, not as a way to make tPA safe.
- Waiting 12 h (D) delays treatment.
- المصدر
- Step Up To Medicine 6th Edition 2024 (STROKE).pdf · p. 6
5. Acute Ischemic Stroke.pdf · p. 5 - المحاضرة
- Weakness: TIA & Stroke · Neurology · Module C
- ظهر في
- MED42 ♀ EOM C