COMMON DIAGNOSIS AND MANAGEMENT IN
ACUTE CARE FINAL PRACTICE TEST PAPER
2026 FULL SOLUTION STUDY SHEET
◉ Contraindications of performing LP. Answer: • Increased risk of
fatal cerebellar or transtentorial herniation; • Coagulopathy; •
Infection over puncture site; • Spinal block requiring sample above
lesion
◉ Common complications of lumbar puncture. Answer: -Sciatic pain
during needle insertion; -Slowing of fluid removal (elevate patient
head)
◉ How is chronic meningitis diagnosed?. Answer: On LP/CSF
analysis or contrast MRI/CT showing leakage into meninges.
Meningeal biopsy if CSF not diagnostic.
◉ Differentials for chronic meningitis. Answer: -Partially treated
suppurative meningitis; -Paranmeningeal infection; -Mycobacterium
TB; -Lyme; -Syphilis; -HIV; -HSV; -Malignancy; -SLE; -Behcet's
◉ Indications for swallow evaluation. Answer: -Hx of dysphasia; -
Observed dysphasia; -Suspected aspiration; -Decreased oral intake; -
Parenteral/enteral feeding
,◉ Medicare coverage of hospice. Answer: • Prognosis of six months
or less if illness runs normal course; • Falls under Medicare Part A
◉ Three common causes of acute ischemic stroke. Answer: 1- Anoxic
injury; 2- Thrombosis in situ; 3- Thrombotic embolism
◉ In ischemic stroke, what area of damage is irreversible?. Answer:
Tissue death at occluded artery (infarction core)
◉ Penumbra. Answer: Area around infarct, salvageable if blood flow
restored
◉ Risk factors for ischemic stroke. Answer: -Advanced age; -HTN
◉ More risk factors for ischemic stroke. Answer: -HLD, DM, oral
contraceptives, obesity, prior TIAs, tobacco, MI, alcohol, sedentary
lifestyle, sickle cell, stimulant drugs, family hx CVA, cardiac
abnormalities
◉ Subjective signs of ischemic stroke. Answer: -Decreased LOC,
dysarthria, facial droop, aphasia, diplopia, visual deficits, sensory
deficits, ataxia, hemiparesis, vertigo
,◉ Critical timeline info for CVA. Answer: "Last known well"
◉ BE FAST. Answer: Balance, Eyes, Face, Arms, Speech, Time
◉ ACA. Answer: Anterior cerebral artery
◉ MCA. Answer: Middle cerebral artery
◉ PCA. Answer: Posterior cerebral artery
◉ Objective symptoms of ACA stroke. Answer: -Urinary
incontinence; -Speech perseveration; -Disinhibition; -Gait apraxia; -
Primitive reflexes; -Altered mental status; -Impaired judgment; -
Contralateral leg>arm weakness
◉ Objective symptoms of MCA stroke. Answer: -Gaze preference; -
Agnosia; -Ipsilateral hemianopsia; -Contralateral
hemiparesis/hypesthesia
◉ Objective symptoms of PCA stroke. Answer: -Impaired memory; -
Cortical blindness; -Altered mental status; -Contralateral
homonymous hemianopsia; -Visual agnosia
◉ Visual agnosia. Answer: Inability to recognize objects
, ◉ Contralateral homonymous hemianopsia. Answer: Loss of vision
in contralateral visual field
◉ Contralateral hypesthesia. Answer: Decreased touch perception
on one side
◉ Agnosia. Answer: Inability to recognize familiar objects
◉ DDx for ischemic stroke. Answer: -Drug toxicity; -Brain tumors; -
Hypertensive encephalopathy; -Conversion disorder
◉ Conversion disorder. Answer: Somatoform disorder with real
symptoms and no physiological basis
◉ Imaging testing for ischemic stroke. Answer: -Non-con CT
(preferred); -MRI brain (DWI); -CT or MR Angio for occlusion
detection
◉ Labs for acute ischemic stroke. Answer: -CBC, Coags, BMP, Cardiac
biomarkers, Toxicology
◉ Emergent treatment of ischemic stroke: outpatient. Answer: -
Transport to stroke center; -Secure airway, oxygenation, perfusion
ACUTE CARE FINAL PRACTICE TEST PAPER
2026 FULL SOLUTION STUDY SHEET
◉ Contraindications of performing LP. Answer: • Increased risk of
fatal cerebellar or transtentorial herniation; • Coagulopathy; •
Infection over puncture site; • Spinal block requiring sample above
lesion
◉ Common complications of lumbar puncture. Answer: -Sciatic pain
during needle insertion; -Slowing of fluid removal (elevate patient
head)
◉ How is chronic meningitis diagnosed?. Answer: On LP/CSF
analysis or contrast MRI/CT showing leakage into meninges.
Meningeal biopsy if CSF not diagnostic.
◉ Differentials for chronic meningitis. Answer: -Partially treated
suppurative meningitis; -Paranmeningeal infection; -Mycobacterium
TB; -Lyme; -Syphilis; -HIV; -HSV; -Malignancy; -SLE; -Behcet's
◉ Indications for swallow evaluation. Answer: -Hx of dysphasia; -
Observed dysphasia; -Suspected aspiration; -Decreased oral intake; -
Parenteral/enteral feeding
,◉ Medicare coverage of hospice. Answer: • Prognosis of six months
or less if illness runs normal course; • Falls under Medicare Part A
◉ Three common causes of acute ischemic stroke. Answer: 1- Anoxic
injury; 2- Thrombosis in situ; 3- Thrombotic embolism
◉ In ischemic stroke, what area of damage is irreversible?. Answer:
Tissue death at occluded artery (infarction core)
◉ Penumbra. Answer: Area around infarct, salvageable if blood flow
restored
◉ Risk factors for ischemic stroke. Answer: -Advanced age; -HTN
◉ More risk factors for ischemic stroke. Answer: -HLD, DM, oral
contraceptives, obesity, prior TIAs, tobacco, MI, alcohol, sedentary
lifestyle, sickle cell, stimulant drugs, family hx CVA, cardiac
abnormalities
◉ Subjective signs of ischemic stroke. Answer: -Decreased LOC,
dysarthria, facial droop, aphasia, diplopia, visual deficits, sensory
deficits, ataxia, hemiparesis, vertigo
,◉ Critical timeline info for CVA. Answer: "Last known well"
◉ BE FAST. Answer: Balance, Eyes, Face, Arms, Speech, Time
◉ ACA. Answer: Anterior cerebral artery
◉ MCA. Answer: Middle cerebral artery
◉ PCA. Answer: Posterior cerebral artery
◉ Objective symptoms of ACA stroke. Answer: -Urinary
incontinence; -Speech perseveration; -Disinhibition; -Gait apraxia; -
Primitive reflexes; -Altered mental status; -Impaired judgment; -
Contralateral leg>arm weakness
◉ Objective symptoms of MCA stroke. Answer: -Gaze preference; -
Agnosia; -Ipsilateral hemianopsia; -Contralateral
hemiparesis/hypesthesia
◉ Objective symptoms of PCA stroke. Answer: -Impaired memory; -
Cortical blindness; -Altered mental status; -Contralateral
homonymous hemianopsia; -Visual agnosia
◉ Visual agnosia. Answer: Inability to recognize objects
, ◉ Contralateral homonymous hemianopsia. Answer: Loss of vision
in contralateral visual field
◉ Contralateral hypesthesia. Answer: Decreased touch perception
on one side
◉ Agnosia. Answer: Inability to recognize familiar objects
◉ DDx for ischemic stroke. Answer: -Drug toxicity; -Brain tumors; -
Hypertensive encephalopathy; -Conversion disorder
◉ Conversion disorder. Answer: Somatoform disorder with real
symptoms and no physiological basis
◉ Imaging testing for ischemic stroke. Answer: -Non-con CT
(preferred); -MRI brain (DWI); -CT or MR Angio for occlusion
detection
◉ Labs for acute ischemic stroke. Answer: -CBC, Coags, BMP, Cardiac
biomarkers, Toxicology
◉ Emergent treatment of ischemic stroke: outpatient. Answer: -
Transport to stroke center; -Secure airway, oxygenation, perfusion
