04-26-2007, 04:59 PM
A 74-year-old woman comes to the emergency department because of a 5-hour history of right-sided weakness. The sudden weakness came on while she was giving her husband a bath. She says that she was sure that she was having a stroke because her husband has had 2 strokes in the past, but her symptoms resolved spontaneously before she arrived at the hospital. She is very concerned about her risk for a stroke because her husband is completely dependent upon her for care. She is able to ambulate normally and has no residual functional loss. Her blood pressure is 110/80 mm Hg and pulse is 70/min. Funduscopic examination is normal. A thorough neurologic examination is unremarkable. The most appropriate next step is to
a) Advise her to take a daily aspirin
b) Auscultate the carotid arteries
c) Obtain an MRI of the head
d) Order a carotid sonogram with Doppler
e) Schedule an elective carotid endarterectomy
a) Advise her to take a daily aspirin
b) Auscultate the carotid arteries
c) Obtain an MRI of the head
d) Order a carotid sonogram with Doppler
e) Schedule an elective carotid endarterectomy