American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the monitoring focus for patients receiving thrombolysis after tPA is administered?

1. Blood glucose levels

2. Neurologic examination

3. Cardiac output

4. Liver function tests

The correct answer is: Neurologic examination

The monitoring focus for patients receiving thrombolysis after tPA administration is a neurologic examination. This is crucial because the primary goal of thrombolytic therapy is to restore blood flow to the affected area of the brain and minimize ischemic damage in patients with acute ischemic stroke. After the administration of tPA, the risk of complications such as intracranial hemorrhage increases. Continuous neurologic assessment allows for the timely detection of any changes in the patient's condition, such as deterioration in neurological status, which may indicate a potential adverse effect of the therapy. Signs of worsening stroke or bleeding are especially important to identify early so that appropriate interventions can be initiated. While monitoring blood glucose levels is important in general stroke management to avoid hypoglycemia or hyperglycemia, and although cardiac output and liver function tests can be relevant in the context of comprehensive patient care, they are not the primary focus immediately following tPA administration in the acute setting. The neurologic examination is paramount to ensure the safety and efficacy of the thrombolytic treatment.