@johnhongkim: The answer is B: the 68-year-old with sudden dizziness and double vision. Dizziness is one of the most common complaints in urgent care and most cases aren’t strokes. But add sudden-onset DOUBLE VISION and the conversation changes immediately. Sudden dizziness/vertigo + diplopia is a red flag for a posterior circulation stroke. Posterior strokes involve areas such as the brainstem and cerebellum, and they don’t always present with the classic FAST symptoms we associate with stroke. Other warning signs can include: • New difficulty walking or severe imbalance • Slurred speech • Trouble swallowing • New weakness or numbness • Abnormal eye movements • Severe headache or neck pain • Nausea/vomiting with new neurologic findings So why does B go before everyone else? A 103°F fever and sore throat needs evaluation. An actively bleeding laceration needs prompt attention and bleeding control. A child with ear pain and vomiting needs assessment. But a possible acute stroke is time-sensitive. Every minute of delayed recognition can mean more brain tissue at risk, and eligibility for acute stroke treatments depends heavily on timing. In urgent care, this isn’t the patient you leave sitting in the waiting room. Sudden dizziness + a new neurologic symptom like diplopia = stroke until proven otherwise. #stroke #medstudents #nurse #nursepractitioner #urgentcare

John Hong Kim

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Monday 07 September 2026 14:07:34 GMT