What diagnostic tests must be completed before thrombolytic administration?
Select an answer:
We laund
Glucose and ECG
Blood glucose and biajin CT/MRI
ECG and troponin
Brain CT/MRI and creatinine
Description: student submitted image, transcription available
Correct Answer: Blood glucose and brain CT/MRI
Explanation (Approx. 300 words):
Before administering thrombolytic therapy, especially for acute ischemic stroke, it is critical to perform certain diagnostic tests to confirm the diagnosis, rule out contraindications, and avoid potentially fatal complications.
Two essential diagnostic tests that must be completed before initiating thrombolytic therapy are:
- Blood Glucose Test
- Brain Imaging (CT or MRI)
1. Blood Glucose Test:
This test is essential to rule out hypoglycemia or hyperglycemia, both of which can mimic stroke symptoms. For instance, hypoglycemia can cause neurological deficits similar to stroke, such as confusion, weakness, or speech difficulty. Administering thrombolytics to someone who is actually hypoglycemic and not having a stroke could expose them to unnecessary bleeding risk without benefit. Conversely, severe hyperglycemia is associated with worse stroke outcomes and may alter treatment decisions.
2. Brain Imaging (CT or MRI):
A non-contrast head CT or MRI must be performed to differentiate between ischemic and hemorrhagic stroke. Thrombolytics are only indicated for ischemic strokes, not hemorrhagic strokes. Administering thrombolytics to a patient with an undiagnosed brain bleed can lead to catastrophic intracranial hemorrhage. The imaging must confirm no signs of intracerebral hemorrhage, large infarction, or other contraindications before proceeding with treatment.
Other Tests (Not Mandatory Before Thrombolysis):
While tests like ECG, troponin, and serum creatinine are important for comprehensive stroke care, they are not required before giving thrombolytics if there are no clinical signs of problems like acute myocardial infarction or kidney failure. These can be performed after thrombolysis is initiated to avoid delays in treatment.
Conclusion:
To safely administer thrombolytics in acute ischemic stroke, blood glucose testing and brain imaging (CT or MRI) are mandatory and must precede treatment.
