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WorksheetsNeurological, GI, & Urological Emergencies Test
Total questions: 21
Worksheet time: 21mins
A 68-year-old man developed a sudden severe headache about 1 hour ago. On assessment he has slurred speech, a left-sided facial droop, and is not moving his left side. Vitals: pulse 100/min, blood pressure 188/110 mm Hg, respirations 22/min. His history includes poorly controlled diabetes and hypertension; blood glucose is 70 mg/dL. As you prepare for transport, he has a generalized seizure. On the basis of this patient’s condition, what should you be most concerned with?
Maintaining the ABCs
Determining the type of stroke
rope
Administering oral glucose
Performing further assessment
For budding prehospital stroke identification in the same 68-year-old patient with slurred speech, facial droop, and left-sided weakness after a sudden headache, which neurologic examination emphasizes these possible stroke signs?
Chicago Prehospital Stroke Scale
Philadelphia Stroke Scale
Cincinnati Prehospital Stroke Scale
Camden Stroke Scale
In the context of acute neurologic emergencies like this patient’s presentation, which process occurs when blood flow to a particular part of the brain is cut off by a blockage resulting in tissue damage?
Ischemic stroke
Hemorrhagic stroke attempt
Seizure
Status epilepticus
After a stroke, what is the condition called when a patient ignores or forgets the injured side of the body?
Hemiparesis
Neglect
Aphasia
Ataxia
This patient experienced a generalized seizure. What criteria must be met for this patient to have status epilepticus?
A seizure lasting greater than 30 minutes
A seizure that was preceded by an aura
The presence of incontinence during the seizure
Multiple seizures with normal consciousness between each event
Which of the following is a metabolic cause for a seizure in a patient like this?
Brain tumor
Head trauma
Hypoglycemia
Brain abscess
This patient appears to be suffering from a stroke and a seizure. Which condition can mimic a stroke and also cause a seizure?
Meningitis
Postictal state
Hypoglycemia
Migraine headache
When using the Glasgow Coma Scale for a neurologic patient such as this one, which response categories must you assess?
Eye opening, verbal response, motor response
Pupillary size, blood pressure, respiratory rate
Orientation, memory, gait
Pain score only
In prehospital stroke care, what best distinguishes a stroke from a transient ischemic attack?
Stroke causes persistent neurologic deficits due to brain injury, whereas a transient ischemic attack causes temporary deficits that resolve completely within 24 hours without permanent damage
A transient ischemic attack is caused by low blood glucose, whereas a stroke is always caused by trauma
Stroke always presents with seizures, whereas a transient ischemic attack never does
A transient ischemic attack causes hypertension, whereas a stroke causes hypotension
Why is it important to determine the time the patient was last seen normal in suspected stroke?
It establishes eligibility for time-sensitive reperfusion therapies and guides destination and treatment decisions
It predicts the risk of a future seizure
It rules out hypoglycemia as a cause of symptoms
It determines whether the patient’s blood pressure is dangerously high
A 63-year-old man at a shelter has 6 hours of abdominal pain and began vomiting about 30 minutes ago. He is now vomiting bright red blood. He has a history of heavy alcohol use and “big liver.” Vitals: pulse 104/min, respirations 22/min, blood pressure 86/58 mm Hg, SpO2 97% on room air; skin pale, cool, and diaphoretic. Based on what you know thus far, which of the following conditions could the patient have?
Peptic ulcers
Cholecystitis
Diverticulitis
Nephritis
Your partner notes blood in the patient’s vomit. What is the medical term for vomiting blood?
Hematemesis
Melena
Hematochezia
Steatorrhea
During your abdominal assessment, the patient tenses his abdominal muscles. What is this finding called?
Rebound tenderness
Tetany
Splinting
Guarding
You suspect upper gastrointestinal bleeding in this patient. All of the following conditions fit into this category, except which one?
Esophageal varices
Hemorrhoids
Esophagitis
Mallory–Weiss tear
Given the patient’s heavy alcohol use, bright red hematemesis, hypotension, and pale, cool, diaphoretic skin, what diagnosis do you most suspect?
Gastroenteritis
Pancreatitis
Esophageal varices
Cholecystitis
For this hypotensive patient with bright red hematemesis, which of the following is an appropriate immediate management step in the field?
High-flow oxygen
Oral glucose
Activated charcoal
Placing the patient supine only
En route to the emergency department, this patient’s condition worsens and he shows signs of shock. What is the most likely cause of his shock?
Hypovolemic hemorrhagic shock from ongoing upper gastrointestinal bleeding
Distributive shock from systemic infection
Cardiogenic shock from acute myocardial infarction
Neurogenic shock from spinal injury
Which combination of findings best supports your working diagnosis for this patient’s condition?
Bright red hematemesis, hypotension, and history of chronic alcohol use/liver disease
Coffee-ground emesis with hypertension and no alcohol history
Right upper quadrant colicky pain after fatty meals without vomiting blood
Lower abdominal cramping with black tarry stools only
When assessing the nature of this patient’s illness, which information is most important to obtain? (Select all that apply.)
Recent alcohol intake and history of liver disease
Onset, location, character, and progression of the pain and vomiting
Use of anticoagulants or NSAIDs
Recent urinary frequency without dysuria
Which urine findings most commonly indicate a pathologic process that warrants further evaluation? (Select all that apply.)
Blood (hematuria)
Protein (proteinuria)
Ketones
Straw-yellow color without odor
Which vessels carry blood to the kidneys and away from the kidneys, respectively?
Renal artery and renal vein
Femoral artery and femoral vein
Aorta and inferior vena cava directly
Hepatic artery and portal vein
