A 52-year-old right-handed woman comes to the emergency department due to speech arrest and right arm weakness

A 52-year-old right-handed woman comes to the emergency department due to speech arrest and right arm weakness. The
symptoms began suddenly at breakfast but resolved after about 30 minutes. The patient has a history of relapsing-remitting multiple
sclerosis. Three months ago, she was hospitalized due to blurry vision in the left eye, which was treated with corticosteroids and
improved after several weeks. The patient’s other medical issues include hypertension and hyperlipidemia. She is currently not
taking any disease-modifying therapy for her multiple sclerosis. She has a 40-pack-year history of tobacco use. Blood pressure is
170/96 mm Hg, and pulse is 92/min. BMI is 35 kg/m2 There is a mild afferent pupillary defect in the left eye with diminished visual
acuity Noncontrast CT scan of the head is unremarkable. Which of the following is the best next step in treatment of this patient?

  • QA Administer intravenous glucocorticoids
  • 0 B. Administer intravenous immunoglobulin
  • 0 C. Administer tissue plasminogen activator
  • 0 D. Initiate aspirin and statin therapy
  • 0 E. Initiate disease-modifying agent
  • 0 F Initiate intravenous heparin infusion
  • 0 G. Initiate plasma exchange therapy

0 voters

Key D