AEMCA AEMCA - Advanced Emergency Medical Care Assistant Neurological Emergencies Questions and Answers 1 — Questions and Answers
Question 1: A patient presents with sudden onset of severe headache described as 'the worst headache of my life.' What condition should you suspect first?
- Tension headache
- Subarachnoid hemorrhage (Correct answer)
- Migraine with aura
- Hypertensive urgency
Correct answer: Subarachnoid hemorrhage
A sudden-onset 'thunderclap' headache is the classic presentation of subarachnoid hemorrhage and requires immediate emergency evaluation.
Question 2: When using the Cincinnati Prehospital Stroke Scale, which THREE components are assessed?
- Facial droop, arm drift, and speech (Correct answer)
- Pupil response, grip strength, and gait
- Blood pressure, heart rate, and GCS
- Visual fields, reflexes, and coordination
Correct answer: Facial droop, arm drift, and speech
The Cincinnati Prehospital Stroke Scale evaluates facial droop, arm drift, and abnormal speech to rapidly identify stroke in the field.
Question 3: A postictal patient becomes increasingly unresponsive 20 minutes after a witnessed tonic-clonic seizure. What is the most concerning possibility?
- Normal postictal state
- Status epilepticus (Correct answer)
- Todd's paralysis
- Vagal syncope
Correct answer: Status epilepticus
Failure to regain consciousness after a seizure raises concern for status epilepticus, which requires immediate intervention.
Question 4: Which finding on pupil assessment is most consistent with herniation syndrome in a head-injured patient?
- Bilateral pinpoint pupils
- Unilateral dilated and fixed pupil (Correct answer)
- Bilateral dilated reactive pupils
- Anisocoria with equal reactivity
Correct answer: Unilateral dilated and fixed pupil
A unilateral dilated and fixed (blown) pupil indicates uncal herniation compressing cranial nerve III and is a neurosurgical emergency.
Question 5: A patient with known epilepsy is having a generalized tonic-clonic seizure lasting more than 5 minutes. What is the first-line prehospital pharmacological intervention?
- IV phenytoin
- IM or IV benzodiazepine (Correct answer)
- IV phenobarbital
- Intranasal ketamine
Correct answer: IM or IV benzodiazepine
Benzodiazepines (e.g., diazepam, lorazepam, or midazolam) are the first-line prehospital agents to terminate prolonged seizures.
Question 6: Which Glasgow Coma Scale (GCS) score indicates severe traumatic brain injury requiring aggressive airway management?
- GCS 13–15
- GCS 9–12
- GCS ≤ 8 (Correct answer)
- GCS 6–9
Correct answer: GCS ≤ 8
A GCS of 8 or less defines severe TBI; these patients cannot protect their airway and require definitive airway management.
AEMCA AEMCA - Advanced Emergency Medical Care Assistant Neurological Emergencies Questions and Answers 1
A patient presents with sudden onset of severe headache described as 'the worst headache of my life.' What condition should you suspect first?