Stroke, Epilepsy, & Cord Compression

1. What is the primary aim of emergency courses?

A) To certify medical specialists
B) To provide administrative training
C) To teach routine hospital procedures
D) To equip individuals with skills for handling critical emergencies

D) To equip individuals with skills for handling critical emergencies

2. Which of the following is NOT typically included in emergency courses?
A) First aid
B) Advanced life support
C) Long-term rehabilitation training
D) Community emergency response

C) Long-term rehabilitation training

4. What is NOT a component of BLS?
A) CPR
B) AED use
C) First aid
D) Advanced airway intubation

D) Advanced airway intubation

5. Who is BLS intended for?
A) Only doctors
B) Only emergency responders
C) Only nurses
D) Healthcare providers and the general public

D) Healthcare providers and the general public

6. ACLS focuses on all the following EXCEPT:
A) Advanced airway management
B) Medication administration
C) AED training
D) Cardiac emergency response

C) AED training

Which of the following is required in emergency medicine practice?
A) Legal documentation skills
B) Basic pharmacology knowledge only
C) Broad knowledge base and technical skills
D) Minimal clinical involvement

C) Broad knowledge base and technical skills

What is the foundation of emergency medical management?
A) Routine lab testing
B) Aesthetic considerations
C) Immediate care
D) Patient discharge plans

C) Immediate care

Which approach is essential in emergency care management?
A) Solo decision-making
B) Team-based approach
C) Radiologic consultation
D) Public health advisory

B) Team-based approach

What are the ABCs of pre-hospital care known to save lives?
A) Action, Behavior, CPR
B) Airway, Breathing, Circulation
C) Alertness, Blood count, CPR
D) Airflow, Balance, Cardioversion

B) Airway, Breathing, Circulation

What is the first responsibility in emergency patient evaluation?
A) To order imaging
B) To stabilize glucose levels
C) To determine which patient is most ill
D) To assign a diagnosis

C) To determine which patient is most ill

What is the term for assessing which patient needs immediate care first?
A) Allocation
B) Prioritization
C) Stratification
D) Triage

D) Triage

What are the three components necessary for triage?
A) Blood test, CT scan, ECG
B) Chief complaint, vital signs, physical assessment
C) Medical history, lab results, medication list
D) Height, weight, BMI

B) Chief complaint, vital signs, physical assessment

Which of the following is a scenario requiring ACLS?
A) A toddler with seizures
B) Adult with cardiac arrest
C) Trauma patient with fractures
D) Child with asthma

B) Adult with cardiac arrest

What is ATLS used for?
A) Adult cardiac arrest
B) Minor infections
C) Severely injured trauma patients
D) Pediatrics with fever

C) Severely injured trauma patients

PALS/APLS focuses on which group?
A) Elderly patients
B) Critically ill or injured children
C) Pregnant women
D) Athletes

B) Critically ill or injured children

Which course is aimed at newborn resuscitation?
A) BLS
B) ATLS
C) ACLS
D) Neonatal resuscitation protocols under PALS/APLS

D) Neonatal resuscitation protocols under PALS/APLS

What 4 scenarios determine the approach to seriously ill patients?

1. Cardiac arrest in adults- Basic/Advanced Life Support- ACLS

2. Assessment and Management of the Severly Injured Patient- ATLS

3. Assessment and Management of the Seriously Ill Adult Patient (Asthma, Pneumonia, Status Epilepticus)

4. 1. Assessment and Management of the Critically Ill or Injured Child- Pediatric Advanced Life Support, Acute Pediatric Life Support (PALS, APLS)

   2. Resuscitation of the Newborn

What is the definition of stroke?
A) Excess blood in muscles
B) Poor blood flow to the brain causing cell death
C) Kidney shutdown
D) Sudden paralysis of the limbs only

B) Poor blood flow to the brain causing cell death

What are the two main types of stroke?
A) Cardiogenic and neurogenic
B) Mechanical and obstructive
C) Ischemic and hemorrhagic
D) Arterial and venous

C) Ischemic and hemorrhagic

Which of the following is NOT another term for stroke?
A) Brain attack
B) Cerebrovascular accident
C) Cardiac ischemia
D) Cerebrovascular insult

C) Cardiac ischemia

Which arteries supply the brain?
A) Pulmonary and femoral
B) Jugular and temporal
C) Internal carotid and vertebral
D) Renal and brachial

C) Internal carotid and vertebral

What are the branches of the internal carotid artery?
A) Basilar artery and subclavian
B) Anterior cerebral, middle cerebral, posterior communicating artery
C) Vertebral artery and anterior spinal artery
D) Temporal and occipital arteries

B) Anterior cerebral, middle cerebral, posterior communicating artery

Where does the vertebral artery originate?
A) From the common carotid
B) From the brainstem
C) From the subclavian artery
D) From the jugular vein

C) From the subclavian artery

What artery forms by union of both vertebral arteries?
A) Middle cerebral
B) Carotid
C) Basilar
D) Anterior spinal

C) Basilar

What are the terminal branches of the basilar artery?
A) Posterior cerebral arteries
B) Middle cerebral arteries
C) Internal carotid arteries
D) Subclavian arteries

A) Posterior cerebral arteries

Where does the basilar artery begin?

at the lower border of pons by the union of the 2 vertebral arteries

What is the Circle of Willis?
A) A venous drainage system
B) A muscle group in the neck
C) An arterial anastomosis supplying the brain
D) A set of lymph nodes in the brain

C) An arterial anastomosis supplying the brain

Which arteries form the Circle of Willis?
A) Only the anterior cerebral arteries
B) Only vertebral and basilar arteries
C) Anterior/posterior cerebral, communicating arteries, and internal carotids
D) Temporal and occipital arteries

C) Anterior/posterior cerebral, communicating arteries, and internal carotids

What is the function of the Circle of Willis?
A) Produces cerebrospinal fluid
B) Ensures cerebral blood supply redundancy
C) Filters brain toxins
D) Transports oxygen directly into neurons

B) Ensures cerebral blood supply redundancy

What defines an ischemic stroke?
A) Bleeding into the brain
B) Transient neurological symptoms
C) Neurological deficit lasting more than >24 hours due to cerebral artery occlusion
D) Stroke symptoms that resolve within 1 hour

C) Neurological deficit lasting more than >24 hours due to cerebral artery occlusion

Which of the following is NOT a risk factor for ischemic stroke?
A) Atrial fibrillation
B) Diabetes
C) Dyslipidemia
D) Appendicitis

D) Appendicitis

What is the most common cause of thrombotic strokes?
A) Brain tumor
B) Spinal cord trauma
C) Atherosclerosis of extracranial vessels (e.g. carotid atheroma)
D) Subdural hematoma

C) Atherosclerosis of extracranial vessels (e.g. carotid atheroma)

What is a common cause of embolic stroke?
A) Pulmonary embolism
B) Atrial fibrillation
C) Bradycardia
D) Epistaxis

B) Atrial fibrillation

. What is paradoxical embolization?
A) Left-to-right shunting of blood
B) Venous clot reaching the lungs
C) Venous clot bypasses lungs into arterial circulation
D) Hemorrhagic stroke due to trauma

C) Venous clot bypasses lungs into arterial circulation

What heart defect most commonly causes paradoxical embolism?
A) Patent ductus arteriosus
B) Patent foramen ovale (PFO)
C) Aortic stenosis
D) Ventricular septal defect

B) Patent foramen ovale (PFO)

What are clinical clues indicating paradoxical embolization?

1. cryptogenic stroke in a young person

2. history of DVT or PE

3. presence of a PFO or ASD (usually diagnosed by bubble contrast echo)

What is a hallmark of stroke onset?
A) Gradual development
B) Sudden onset in seconds to minutes
C) No noticeable symptoms
D) Onset only at night

B) Sudden onset in seconds to minutes

Which of the following is NOT a symptom of ischemic stroke?
A) Hemiplegia
B) Aphasia
C) Gradual loss of appetite
D) Coma

C) Gradual loss of appetite

Which test must be done immediately upon stroke presentation?
A) Blood glucose
B) GCS
C) EEG
D) Thyroid panel

B) GCS

What GCS score requires ICU admission and intubation?
A) 12
B) 9
C) 10
D) Below 8

D) Below 8