NMS Q&A Family Medicine

Cerebrovascular Disease 57(A) A noncontrast CT scan of the head(B) A CT scan of the head with contrast(C) A magnetic resonance imaging (MRI) study ofthe brain(D) Skull x-rays(E) Lumbar puncture to look for red blood cells inthe cerebrospinal fluid14 A 65-year-old hypertensive white man who smokeshas developed right hemiplegia and expressive aphasiaover a period of 15 minutes while on a huntingtrip. The attack occurred 30 hours ago, and his conditionhas not changed in the interim. He had complainedof headache at the time of onset. At this timehe is unable to communicate his symptoms andseems confused aside from his aphasia. Which of thefollowing features is the most probable cause of thisclinical condition?(A) Thrombotic stroke(B) Metastatic carcinoma from the lung(C) Hemorrhagic stroke(D) Neurologic migraine(E) Transient ischemic attack (TIA)15 Which of the following orders would be most appropriatefor a 67-year-old male patient with a BP of160/95 who suffered an ischemic thrombotic stroke2 hours earlier and who has a pronounced left hemiparesisand a noncontrast CT scan of the head thatreveals no intracerebral hemorrhage?(A) Coumadin(B) A low-salt, low-cholesterol diet(C) Rapid reduction of his BP with labetalol until itis about 120/80(D) Ticlopidine(E) Intravenous tissue plasminogen activator