AMLS Neurological Emergencies 3

Question 1

A patient presents with sudden unilateral weakness, aphasia, and visual field deficit. These symptoms resolve completely within 30 minutes. This is most consistent with:

Accepted Answer

Transient ischemic attack (TIA)

Answer

TIA presents with stroke-like symptoms that fully resolve, typically within minutes to less than 24 hours, without infarction on imaging.

Question 2

What is the Cushing reflex and what does it indicate?

Accepted Answer

Hypertension, bradycardia, and irregular respirations indicating increased intracranial pressure

Answer

The Cushing reflex (hypertension, bradycardia, irregular respirations) is a late sign of severely elevated ICP indicating impending herniation.

Question 3

Which intervention is contraindicated in a patient with ischemic stroke who is a tPA candidate?

Accepted Answer

Administering anticoagulants prior to tPA

Answer

Anticoagulants should not be given before tPA in ischemic stroke as they increase bleeding risk and are part of exclusion criteria.

Question 4

A patient with known epilepsy has a seizure that self-terminates in 2 minutes. They are postictal. Which assessment is still critical?

Accepted Answer

Blood glucose to rule out hypoglycemia

Answer

Hypoglycemia can trigger seizures and must be ruled out even in known epileptics, as it is a rapidly reversible cause.

Question 5

Decerebrate posturing in a comatose patient indicates injury at which neurological level?

Accepted Answer

At or below the midbrain (diencephalon to brainstem)

Answer

Decerebrate posturing (extension of all extremities) indicates injury at the midbrain or below, signaling severe brainstem dysfunction.

AMLS - Advanced Medical Life Support Practice Test

AMLS - Advanced Medical Life Support Practice Test

AMLS Neurological Emergencies 3