68-year-old man is brought to the emergency department for acute right-sided hemiplegia

68-year-old man is brought to the emergency department for acute right-sided hemiplegia, headache, and impaired consciousness.

His symptoms started an hour ago and are progressively getting worse. He has no prior history of transient ischemic attack. His

medical problems include obesity, gout, benign prostatic hyperplasia, benign essential tremor, hypertension, and

hypercholesterolemia The patient’s medications include allopurinol, tamsulosin, propranolol, amlodipine, and simvastatin. He has

smoked a pack of cigarettes daily for 15 years Neurological examination shows right-sided weakness and hemi-sensory loss. There

is a carotid bruit on his left side. Which of the following is the most appropriate next step in management?

  • QA Anticoagulation with heparin
  • 0 B. Carotid Doppler
  • 0 C. CT angiography of the head and neck
  • 0 D. CT of the head without contrast
  • 0 E. Echocardiogram
  • 0 F MRI of the brain
  • 0 G. Treatment with aspirin

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