امرأة عمرها ٦٥ سنة عندها ارتفاع ضغط، جاءت الطوارئ بضعف مفاجئ في يدها اليمنى وصعوبة كلام بدأت قبل ٩٠ دقيقة. الضغط ١٧٢/٩٦، والنبض ٨٨، والسكر ١١٨. ما الأولوية بعد تقييم مجرى الهواء والتنفس؟

A 65-year-old hypertensive woman arrives with sudden right hand weakness and speech difficulty that began 90 minutes ago. BP 172/96, HR 88, glucose 118 mg/dL. After assessing airway and breathing, what is the priority?

1. Aspirin 300 mg immediately before any imaging
2. Food and water because she has been fasting
3. Lowering BP to 120/80 straight away
4. An urgent head CT

Answer: D) An urgent head CT. In acute stroke, urgent imaging distinguishes infarct from haemorrhage before any antithrombotic or thrombolytic. Aspirin follows exclusion of bleeding, and nothing is given orally before a swallow screen.