Physician Assistant Physician Assistant Neurological System Disorders

Question 1

A 65-year-old male presents with sudden onset right-sided facial droop, arm weakness, and aphasia that resolved completely within 45 minutes. What is the most likely diagnosis?

Accepted Answer

Transient ischemic attack (TIA)

Answer

A transient ischemic attack (TIA) presents with stroke-like symptoms that resolve completely within 24 hours (typically minutes), with no infarction on imaging.

Question 2

Which of the following is the most common type of stroke?

Accepted Answer

Ischemic stroke

Answer

Ischemic stroke accounts for approximately 87% of all strokes, caused by thrombotic or embolic occlusion of cerebral vessels.

Question 3

A patient presents with thunderclap headache described as 'the worst headache of my life.' CT head is negative. What is the next most appropriate step?

Accepted Answer

Lumbar puncture to check for xanthochromia

Answer

When CT is negative in a patient with thunderclap headache, lumbar puncture to detect xanthochromia is essential to rule out subarachnoid hemorrhage, which may not appear on CT after several hours.

Question 4

What is the time window for administration of IV alteplase (tPA) in acute ischemic stroke?

Accepted Answer

Within 3–4.5 hours of symptom onset

Answer

IV alteplase is approved for administration within 3 hours of symptom onset, with select patients eligible up to 4.5 hours based on AHA/ASA guidelines.

Question 5

Which of the following is a contraindication to IV tPA in acute ischemic stroke?

Accepted Answer

Ischemic stroke or head trauma within the past 3 months

Answer

Recent ischemic stroke or serious head trauma within the prior 3 months is an absolute contraindication to IV tPA due to the risk of hemorrhagic transformation.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Physician Assistant Neurological System Disorders