Medicine
Neurology
Which bedside test should be checked immediately in a patient with ongoing seizure activity?
A. Fasting lipid profile
B. Skin-prick allergy test
C. Capillary blood glucose
D. Bone-density scan
Correct Answer: C
Hypoglycemia is rapidly reversible and can precipitate seizures, so glucose should be checked immediately.
Medicine
Neurology
Which complication or major adverse outcome is particularly associated with Convulsive status epilepticus?
A. Falls and aspiration risk in advanced disease
B. Hypoxic brain injury and rhabdomyolysis
C. Respiratory failure
D. Myasthenic respiratory crisis
Correct Answer: B
Prolonged convulsions can cause hypoxemia, hyperthermia, metabolic injury and muscle breakdown.
Medicine
Neurology
A patient is diagnosed with Convulsive status epilepticus. Which is the most appropriate management principle?
A. Give a benzodiazepine promptly followed by an appropriate longer-acting antiseizure medicine if seizures continue
B. Urgent neurosurgical or neurovascular management with stabilization and prevention of rebleeding and secondary injury
C. Use individualized dopaminergic therapy and multidisciplinary rehabilitation
D. Use intravenous immunoglobulin or plasma exchange for significant disease and closely monitor respiratory and autonomic function
Correct Answer: A
Rapid benzodiazepine therapy is first-line because prolonged seizures increase neuronal and systemic injury.
Medicine
Neurology
In a patient with suspected Convulsive status epilepticus, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical diagnosis when the history is typical and neurologic examination is normal
B. Urgent noncontrast CT brain followed by further evaluation if suspicion remains despite nondiagnostic initial imaging
C. Clinical neurologic diagnosis; imaging is used mainly when an alternative diagnosis is suspected
D. Bedside glucose and urgent evaluation for metabolic, toxic, structural and infectious causes
Correct Answer: D
Immediate reversible causes such as hypoglycemia must be identified while seizure treatment begins.
Medicine
Neurology
A patient has ongoing generalized convulsions without recovery of consciousness. What is the most likely diagnosis?
A. Transient ischemic attack (TIA)
B. Migraine with aura
C. Convulsive status epilepticus
D. Subarachnoid hemorrhage
Correct Answer: C
Prolonged or recurrent seizures without recovery constitute a neurologic emergency.
Medicine
Neurology
Why should a resolved TIA not be managed as a routine nonurgent outpatient complaint?
A. TIAs never recur
B. Risk of early ischemic stroke is clinically important
C. Resolved symptoms exclude vascular disease
D. TIA has no relationship to stroke
Correct Answer: B
TIA is an important warning of possible imminent stroke and warrants urgent assessment.
Medicine
Neurology
Which complication or major adverse outcome is particularly associated with Transient ischemic attack (TIA)?
A. Completed ischemic stroke
B. Myasthenic respiratory crisis
C. Cerebral edema or hemorrhagic transformation
D. Hypoxic brain injury and rhabdomyolysis
Correct Answer: A
Early stroke risk is substantial after a TIA, especially when vascular disease is untreated.
Medicine
Neurology
A patient is diagnosed with Transient ischemic attack (TIA). Which is the most appropriate management principle?
A. Use intravenous immunoglobulin or plasma exchange for significant disease and closely monitor respiratory and autonomic function
B. Use symptomatic acetylcholinesterase inhibition and individualized immunotherapy; treat myasthenic crisis in a monitored setting
C. Activate a stroke pathway and assess urgently for intravenous thrombolysis and/or mechanical thrombectomy when eligible
D. Start rapid secondary stroke prevention based on etiology and bleeding risk
Correct Answer: D
Antiplatelet therapy, risk-factor treatment and targeted management of carotid or cardiac causes reduce early stroke risk.
Medicine
Neurology
In a patient with suspected Transient ischemic attack (TIA), which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical neurologic diagnosis; imaging is used mainly when an alternative diagnosis is suspected
B. Neurologic assessment including respiratory function with CSF and nerve-conduction studies when appropriate
C. Urgent brain and vascular evaluation plus cardiac rhythm assessment
D. Acetylcholine-receptor antibody testing with electrodiagnostic studies when needed
Correct Answer: C
TIA is a warning event; evaluation searches for carotid, intracranial and cardioembolic sources.
Medicine
Neurology
A patient has a brief focal neurologic deficit that fully resolves without persistent objective deficit. What is the most likely diagnosis?
A. Subarachnoid hemorrhage
B. Transient ischemic attack (TIA)
C. Parkinson disease
D. Guillain-Barré syndrome
Correct Answer: B
Transient focal neurologic symptoms due to cerebral ischemia require urgent stroke-risk evaluation even when they resolve.
Medicine
Neurology
What is the first imaging priority in most patients with suspected acute stroke?
A. Rapid noncontrast CT brain
B. Elective skull X-ray
C. Routine lumbar puncture before imaging
D. Outpatient EEG only
Correct Answer: A
Noncontrast CT rapidly distinguishes intracranial hemorrhage from ischemic stroke presentations.
Medicine
Neurology
Which complication or major adverse outcome is particularly associated with Acute ischemic stroke?
A. Hypoxic brain injury and rhabdomyolysis
B. Medication-overuse headache
C. Cerebral vasospasm with delayed ischemia
D. Cerebral edema or hemorrhagic transformation
Correct Answer: D
Large infarcts can swell and reperfused infarcts can undergo hemorrhagic transformation.
Medicine
Neurology
A patient is diagnosed with Acute ischemic stroke. Which is the most appropriate management principle?
A. Start rapid secondary stroke prevention based on etiology and bleeding risk
B. Give a benzodiazepine promptly followed by an appropriate longer-acting antiseizure medicine if seizures continue
C. Activate a stroke pathway and assess urgently for intravenous thrombolysis and/or mechanical thrombectomy when eligible
D. Use acute migraine therapy and consider preventive treatment when attacks are frequent or disabling
Correct Answer: C
Time-sensitive reperfusion improves outcomes in selected acute ischemic stroke patients.
Medicine
Neurology
In a patient with suspected Acute ischemic stroke, which investigation or diagnostic approach is most appropriate at this stage?
A. Acetylcholine-receptor antibody testing with electrodiagnostic studies when needed
B. Immediate noncontrast CT brain with rapid vascular assessment as indicated
C. Urgent brain and vascular evaluation plus cardiac rhythm assessment
D. Bedside glucose and urgent evaluation for metabolic, toxic, structural and infectious causes
Correct Answer: B
Initial imaging excludes hemorrhage and helps determine eligibility for reperfusion therapy.
Medicine
Neurology
A patient develops sudden unilateral weakness and aphasia with a clear time of symptom onset. What is the most likely diagnosis?
A. Acute ischemic stroke
B. Guillain-Barré syndrome
C. Myasthenia gravis
D. Transient ischemic attack (TIA)
Correct Answer: A
A sudden focal neurologic deficit is a stroke until proven otherwise.