A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two (2) weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?
A. CBC (Complete blood count)
B. ECG (electrocardiogram)
C. Thyroid function tests
D. CT scan
Correct Answer: D. CT scan
A CT scan would be performed for further investigation of the hemiparesis. Noncontrast CT scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke.
Option A: A complete blood count (CBC) and a basic chemistry panel can be useful baseline studies. A CBC serves as a baseline study and may reveal a cause for the stroke (eg, polycythemia, thrombocytosis, thrombocytopenia, leukemia), identify evidence of concurrent illness (eg, anemia), or issues that may affect reperfusion strategies (thrombocytopenia).
Option B: Electrocardiogram may serve as baseline data upon entry into the ED. An electrocardiogram (ECG or EKG) records the electrical signal from the heart to check for different heart conditions. Electrodes are placed on the chest to record the heart’s electrical signals, which cause the heart to beat. The signals are shown as waves on an attached computer monitor or printer.
Option C: Testing can often be limited to blood glucose, plus coagulation studies if the patient is on warfarin, heparin, or one of the newer antithrombotic agents (eg, dabigatran, rivaroxaban), not including thyroid studies.