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Retired NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 2/Question#15 (reveal difficulty score)
A 77-year-old man is brought to the physician ...
CT scan of the head ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: Neuro

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submitted by โˆ—carolebaskin(109)
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He's probably having an ischemic stroke

But you can't be sure!

First step is non-con CT


Other wrong answers:

  • Don't do an LP until you know there is no bleed; they could herniate!

  • EEG has no place in acute stroke w/u

  • Carotid duplex US helps find source of stroke, but doesn't help in acute w/u

  • angiography maybe later

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submitted by โˆ—bwdc(697)
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The first imaging test in acute stroke is a noncontrast CT scan of the head. At 12 hours out, it may show ischemic strokes, but more importantly, it will diagnose hemorrhagic strokes, for which reperfusion and antiplatelet therapies are contraindicated.

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