DCAS Neurological Emergencies 3

Question 1

A head-injured patient develops a fixed, dilated pupil on one side and a decreasing GCS. This finding most likely indicates:

Accepted Answer

Uncal herniation compressing cranial nerve III

Answer

Bilateral cortical contusion

Answer

Basilar skull fracture

Answer

Epidural haematoma with no herniation

Question 2

In the UAE pre-hospital setting, which drug is typically used as first-line treatment for a paediatric patient in status epilepticus without IV access?

Accepted Answer

Intranasal or buccal midazolam

Answer

IV phenobarbital

Answer

Rectal paraldehyde

Answer

IV valproate loading dose

Question 3

The current thrombolysis (tPA) time window from symptom onset for eligible ischaemic stroke patients is generally:

Accepted Answer

Up to 3–4.5 hours

Answer

Up to 1 hour

Answer

Up to 6 hours only for posterior circulation

Answer

Up to 12 hours for all patients

Question 4

The AVPU scale rates a patient as 'V'. What does this indicate?

Accepted Answer

Patient responds only to Voice

Answer

Patient is fully Alert and oriented

Answer

Patient responds only to Pain

Answer

Patient is Unresponsive

Question 5

A patient describes the worst headache of their life, with sudden onset ('thunderclap' headache). Which condition must be immediately suspected?

Accepted Answer

Subarachnoid haemorrhage (SAH)

Answer

Cluster headache

Answer

Tension headache exacerbation

Answer

Cervicogenic headache

Question 6

Which clinical feature helps differentiate Bell's palsy from a stroke-related facial palsy?

Accepted Answer

Ability to wrinkle the forehead on the affected side in stroke

Answer

Facial palsy on the left side only

Answer

Inability to wrinkle the forehead on the affected side in stroke

Answer

Drooling of saliva

Question 7

A patient with suspected central vertigo (rather than benign peripheral vertigo) would most likely present with which additional finding?

Accepted Answer

Diplopia, dysarthria, or limb ataxia

Answer

Positive Dix-Hallpike test that fatigues with repetition

Answer

Nausea and vomiting in isolation

Answer

Tinnitus and unilateral hearing loss only