A patient presents with sudden numbness and weakness, confusion, and trouble speaking. MRI is performed and thrombolytic therapy (tPA) is ordered. What condition could the physician be treating?

A patient presents with sudden numbness and weakness, confusion, and trouble speaking. MRI is performed and thrombolytic therapy (tPA) is ordered. What condition could the physician be treating?

• A. Ischemic stroke
• B. Hemorrhagic stroke
• C. Transient ischemic attack
• D. Brain tumor

Answer: (A)

This item centers on recognizing an acute ischemic stroke and the use of thrombolysis with tPA. The sudden onset of focal neurologic deficits—numbness and weakness on one side, confusion, and trouble speaking—fits a vascular event where a blood clot blocks a brain artery. When imaging shows no bleeding, dissolving that clot with tissue plasminogen activator can restore blood flow and limit brain injury, ideally within a short time window after symptoms begin. This approach isn’t used for hemorrhagic stroke, because dissolving clots in a bleeding brain would worsen the hemorrhage. A transient ischemic attack can mimic these symptoms but resolves quickly and doesn’t involve a persistent infarct, so thrombolysis isn’t indicated. A brain tumor would present differently and isn’t treated with emergency clot-busting therapy.

This item centers on recognizing an acute ischemic stroke and the use of thrombolysis with tPA. The sudden onset of focal neurologic deficits—numbness and weakness on one side, confusion, and trouble speaking—fits a vascular event where a blood clot blocks a brain artery. When imaging shows no bleeding, dissolving that clot with tissue plasminogen activator can restore blood flow and limit brain injury, ideally within a short time window after symptoms begin.

This approach isn’t used for hemorrhagic stroke, because dissolving clots in a bleeding brain would worsen the hemorrhage. A transient ischemic attack can mimic these symptoms but resolves quickly and doesn’t involve a persistent infarct, so thrombolysis isn’t indicated. A brain tumor would present differently and isn’t treated with emergency clot-busting therapy.