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

A unilateral fixed dilated pupil in a deteriorating head-injured patient indicates uncal herniation compressing the ipsilateral oculomotor nerve (CN III), a neurosurgical emergency.

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

Intranasal or buccal midazolam is the preferred first-line agent when IV access is unavailable in paediatric status epilepticus due to ease of administration and rapid onset.

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

The established tPA treatment window for ischaemic stroke is 3–4.5 hours from symptom onset in eligible patients, making rapid pre-hospital identification critical.

Question 4

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

Accepted Answer

Patient responds only to Voice

Answer

In the AVPU scale, 'V' indicates the patient responds to verbal stimuli but is not spontaneously alert, corresponding roughly to a GCS of 9-13.

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

A sudden-onset 'thunderclap' headache described as the worst of the patient's life is the classic presentation of subarachnoid haemorrhage until proven otherwise.

DCAS Practice Test

DCAS Practice Test

DCAS Neurological Emergencies 3