AMLS Neurological Emergencies 1 — Questions and Answers
Question 1: What is the recommended time window for administering IV alteplase (tPA) in ischemic stroke from symptom onset?
- Within 3 to 4.5 hours (Correct answer)
- Within 1 hour
- Within 6 hours
- Within 12 hours
Correct answer: Within 3 to 4.5 hours
IV alteplase can be administered within 3 to 4.5 hours of symptom onset in eligible ischemic stroke patients.
Question 2: A patient presents with sudden-onset worst headache of their life. Which condition must be immediately suspected?
- Subarachnoid hemorrhage (Correct answer)
- Tension headache
- Cluster headache
- Migraine with aura
Correct answer: Subarachnoid hemorrhage
A thunderclap headache described as the worst of one's life is the hallmark of subarachnoid hemorrhage until proven otherwise.
Question 3: Which Cincinnati Prehospital Stroke Scale finding indicates facial droop?
- One side of the face does not move as well as the other side (Correct answer)
- Patient cannot smile at all
- Patient's mouth deviates toward the weak side only with grimace
- Both sides of the face move equally
Correct answer: One side of the face does not move as well as the other side
Facial droop on the Cincinnati scale is when one side of the face does not move symmetrically when the patient shows teeth or smiles.
Question 4: What is the most common cause of nontraumatic intracerebral hemorrhage?
- Hypertension (Correct answer)
- Arteriovenous malformation
- Anticoagulation therapy
- Brain tumor
Correct answer: Hypertension
Chronic hypertension is the most common cause of spontaneous intracerebral hemorrhage, leading to rupture of small penetrating arteries.
Question 5: Which of the following signs suggests herniation in a deteriorating stroke patient?
- Ipsilateral dilated and fixed pupil with contralateral hemiplegia (Correct answer)
- Bilateral miosis with normal consciousness
- Bilateral mydriasis with normal motor function
- Alternating pupil dilation
Correct answer: Ipsilateral dilated and fixed pupil with contralateral hemiplegia
Uncal herniation causes compression of CN III, producing an ipsilateral fixed dilated pupil and contralateral hemiplegia.
Question 6: Status epilepticus is defined as a seizure lasting longer than how many minutes?
- 5 minutes (Correct answer)
- 2 minutes
- 10 minutes
- 30 minutes
Correct answer: 5 minutes
Status epilepticus is defined as continuous seizure activity lasting 5 or more minutes or two seizures without recovery of consciousness between them.
AMLS Neurological Emergencies 1
What is the recommended time window for administering IV alteplase (tPA) in ischemic stroke from symptom onset?