Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What is the time window for the administration of tPA in stroke patients?

1 hour
3 hours
4.5 hours
6 hours

The correct answer is: 4.5 hours

The administration of tPA (tissue plasminogen activator), a thrombolytic agent used for treating patients with acute ischemic stroke, is generally recommended within a specific time window to maximize its efficacy and minimize potential risks. The correct choice of 4.5 hours reflects current guidelines, which suggest that tPA should be given as soon as possible, ideally within the first three hours after symptom onset. However, it can also be administered up to 4.5 hours for select patients who meet specific criteria based on their medical history and the nature of their stroke. Timing is crucial in stroke management because the likelihood of achieving a good clinical outcome decreases significantly as time passes. Beyond this time frame, the risks associated with tPA administration, such as intracerebral hemorrhage, begin to outweigh the benefits. Therefore, the established time window of 4.5 hours serves as a guideline to ensure that patients receive the most effective treatment while mitigating potential complications.