Afghanistan Specialization Entry Exam Practice Questions - Afghanistan Medical Specialization (Takhasus) Entry Exam

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A 62-year-old male with a history of long-standing hypertension presents with an acute right-sided hemiparesis and motor aphasia starting 75 minutes ago. Non-contrast CT of the head rules out intracranial hemorrhage and shows an ASPECTS score of 10. Blood pressure is 170/95 mmHg, and blood glucose is 130 mg/dL. He has no history of surgery, bleeding diathesis, or recent trauma. What is the most appropriate next step in management?

Administer oral aspirin 325 mg and clopidogrel 300 mg immediately Initiate intravenous unfractionated heparin with target aPTT of 60-80 seconds Administer intravenous recombinant tissue plasminogen activator (rtPA / alteplase) Lower systolic blood pressure to below 120 mmHg using intravenous sodium nitroprusside

Correct Answer:

Administer intravenous recombinant tissue plasminogen activator (rtPA / alteplase)

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