Typical exam stem
A 64-year-old develops sudden right-sided weakness and aphasia 90 minutes before arrival. Describe your immediate assessment and management.
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
What are common stroke mimics?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Time is brain
Start by confirming the time the patient was last known well. This single detail determines eligibility for time-dependent reperfusion pathways. Use a structured stroke assessment, check capillary glucose early and identify mimics such as hypoglycaemia, seizure with postictal deficit, migraine, intoxication and functional neurological disorder.
Stabilise airway, breathing and circulation without delaying neuroimaging. Treat hypoxaemia, major temperature disturbance and severe glucose abnormalities while obtaining urgent stroke-team review.
Imaging and reperfusion decisions
- Urgent non-contrast CT brain distinguishes haemorrhage from an ischaemic presentation and identifies important alternatives.
- CT angiography is used when large-vessel occlusion is suspected and thrombectomy may be appropriate.
- Selected patients may require advanced imaging to assess salvageable tissue, especially in extended or uncertain time windows.
- Intravenous thrombolysis and mechanical thrombectomy have separate eligibility criteria; a thrombectomy candidate may also be eligible for intravenous thrombolysis.
Do not forget early supportive care
- Swallow screening before oral intake.
- Assessment for aspiration, pressure injury, venous thromboembolism and immobility complications.
- Appropriate antithrombotic therapy after haemorrhage has been excluded and reperfusion decisions are complete.
- Early rehabilitation and secondary prevention based on stroke mechanism.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.