DCAS Neurological Emergencies 2 — Questions and Answers
Question 1: Which type of stroke is caused by a ruptured blood vessel in the brain?
- Ischaemic stroke
- Embolic stroke
- Haemorrhagic stroke (Correct answer)
- Thrombotic stroke
Correct answer: Haemorrhagic stroke
A haemorrhagic stroke results from rupture of a cerebral blood vessel, causing bleeding into or around the brain tissue.
Question 2: A patient presents with severe headache, neck stiffness (nuchal rigidity), and photophobia. Which condition should be immediately suspected?
- Migraine with aura
- Cluster headache
- Bacterial meningitis (Correct answer)
- Tension-type headache
Correct answer: Bacterial meningitis
The classic triad of severe headache, neck stiffness, and photophobia in a febrile patient strongly suggests bacterial meningitis, a life-threatening neurological emergency.
Question 3: A patient opens their eyes to voice, makes confused verbal responses, and localises to pain. What is their GCS score?
- 10
- 11 (Correct answer)
- 12
- 13
Correct answer: 11
Eyes to voice = 3, confused verbal = 4, localises to pain (motor) = 5; total GCS = 3+4+5 = 11 (E3V4M5).
Question 4: The AEIOU-TIPS mnemonic is used to assess causes of altered consciousness. What does the letter 'T' represent?
- Temperature (hypo/hyperthermia)
- Trauma or Toxins (Correct answer)
- Tachycardia
- Thrombosis only
Correct answer: Trauma or Toxins
In AEIOU-TIPS, 'T' stands for Trauma or Toxins (including drugs and poisoning), both of which are common reversible causes of altered level of consciousness.
Question 5: A patient suddenly loses consciousness, recovers spontaneously within 1-2 minutes, and reports no confusion afterward. Which condition is most likely?
- Generalised tonic-clonic seizure
- Haemorrhagic stroke
- Vasovagal syncope (Correct answer)
- Hypoglycaemic episode
Correct answer: Vasovagal syncope
Vasovagal syncope typically presents as a brief, self-resolving loss of consciousness with rapid full recovery and no postictal confusion, distinguishing it from seizure.
Question 6: Cushing's triad — hypertension, bradycardia, and irregular respirations — indicates which life-threatening condition?
- Cardiogenic shock
- Neurogenic shock
- Increased intracranial pressure (ICP) with brainstem herniation (Correct answer)
- Anaphylaxis
Correct answer: Increased intracranial pressure (ICP) with brainstem herniation
Cushing's triad is a late, ominous sign of severely elevated intracranial pressure causing brainstem compression and impending herniation.
Question 7: Which intervention is CONTRAINDICATED in a patient with a suspected haemorrhagic stroke?
- Oxygen supplementation if SpO2 < 94%
- IV access and fluid management
- Aspirin 300 mg administration (Correct answer)
- ECG monitoring
Correct answer: Aspirin 300 mg administration
Aspirin is contraindicated in haemorrhagic stroke as its antiplatelet effect worsens bleeding; it is only appropriate for confirmed ischaemic stroke.
DCAS Neurological Emergencies 2
Which type of stroke is caused by a ruptured blood vessel in the brain?