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Question 1: An 8-year-old African-American female with a history of sickle cell anemia is admitted for pain control during an acute pain crisis. On hospital day 2, she has right facial droop, and right-sided weakness. CT scan confirms the diagnosis. What is the next step in management?

  1. Alteplase

  2. Heparin drip

  3. MRI brain

  4. Tranexamic acid (TXA)

  5. Exchange transfusion

 

Reference: 1. Janz TG, Hamilton GC. Chapter 121: Anemia, Polycythemia, and White Blood Cell Disorders. Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 8th ed. Philadelphia, PA: Elsevier. 2014. 2. Dunn CJ, Gao KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs. 1999;57(6):1005-32.

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