MRCP2-3496

MRCP2-3496

A 75-year-old male has two episodes of weakness affecting the right arm and leg each lasting ten minutes, both within the space of 2 days. He did not attend the emergency department after the first episode. His only significant past medical history is hypertension, for which he takes lisinopril 10 mg OD. He has experienced one similar episode to this one year ago but did not seek medical attention. His son is present who informs you that the patient has lost a significant amount of weight in the last year. On further questioning, he reports some haemoptysis lately. His blood pressure in the department was 160/90 mmHg initially.

His bloods reveal:

Hb 12.0 g/dl
Platelets 155 * 109/l
WBC 12.8 * 109/l

Na+ 135 mmol/l
K+ 4.9 mmol/l
Creatinine 98 µmol/l
CRP 12 mg/l

ECG: Sinus tachycardia, rate 100/min

What is the most appropriate management for this gentleman?