A 56-year-old man is brought to the emergency department due t | Uworld | Step 2ck

A 56-year-old man is brought to the emergency department due to difficulty speaking and paralysis of the right side of his body since he awoke this morning. The patient has not seen a primary care physician for many years and takes no medications. Two years ago, he was told that his blood pressure was elevated during a visit to the dentist He has a 30-pack-year smoking history and drinks 1 or 2 cans of beer daily. The patient has a sedentary lifestyle and a diet consisting mostly of fast food. His father had a stroke at age 60. Blood pressure is 170/95 mm Hg and pulse is 94/min. BMI is 34 kg/m2. The patient's speech is dysarthric. Weakness of the right lower face and right upper and lower extremities is present There is decreased pinprick sensation on the right side of the lower face and body. Right-sided deep tendon reflexes are brisk, and Babinski sign is present on the right Noncontrast CT scan of the head reveals no hemorrhage. Serum LDL is 190 mg/dl and HbA 1 c is 8%.