BCEN BCEN Neurological Emergencies 2 — Questions and Answers
Question 1: Which stroke syndrome presents with ipsilateral facial weakness and contralateral body weakness?
- Lacunar stroke
- Middle cerebral artery stroke (Correct answer)
- Posterior inferior cerebellar artery stroke
- Wallenberg syndrome
Correct answer: Middle cerebral artery stroke
MCA strokes often cause contralateral hemiplegia with face and arm involvement, as MCA supplies the primary motor cortex.
Question 2: A patient post-seizure is confused and lethargic. What is this period called?
- Absence episode
- Todd's paralysis
- Postictal state (Correct answer)
- Focal onset seizure
Correct answer: Postictal state
The postictal state is a transient period of confusion and fatigue that follows a seizure as the brain recovers.
Question 3: Which of the following is the priority intervention for a patient with a suspected spinal cord injury?
- Immediate MRI
- IV methylprednisolone bolus
- Spinal immobilization (Correct answer)
- Lumbar puncture
Correct answer: Spinal immobilization
Spinal immobilization is the immediate priority to prevent secondary injury from movement before definitive imaging and diagnosis.
Question 4: Battle's sign (bruising over the mastoid process) is associated with which type of injury?
- Subdural hematoma
- Basilar skull fracture (Correct answer)
- Epidural hematoma
- Cervical spine fracture
Correct answer: Basilar skull fracture
Battle's sign is a delayed ecchymosis behind the ear that indicates a basilar skull fracture at the posterior fossa.
Question 5: A patient has weakness, diplopia, and dysphagia that worsen throughout the day. What neurological emergency should be suspected?
- Guillain-Barré syndrome
- Myasthenia gravis crisis (Correct answer)
- Multiple sclerosis exacerbation
- Transient ischemic attack
Correct answer: Myasthenia gravis crisis
Myasthenic crisis presents with fatigable weakness that worsens with activity and may require ventilatory support.
Question 6: What is the primary concern when managing a patient with Guillain-Barré syndrome in the ED?
- Hypertensive emergency
- Respiratory failure from ascending paralysis (Correct answer)
- Seizure activity
- Cerebral edema
Correct answer: Respiratory failure from ascending paralysis
Guillain-Barré syndrome causes ascending demyelinating paralysis that can reach the diaphragm, necessitating close respiratory monitoring.
BCEN BCEN Neurological Emergencies 2
Which stroke syndrome presents with ipsilateral facial weakness and contralateral body weakness?