PAEA Internal Medicine EOR Testbank
2026 Question and Answer | Real
Questions and Answers | A+ Verified
• Define stroke -✓✓any disease process that interrupts blood flow to the
brain. can be ischemic or hemorrhagic
• gold standard diagnostic test for stroke -✓✓CT angiogram
• S/sx of a stroke -✓✓-sudden numbness/weakness,
-sudden confusion/aphasia,
-memory deficit,
-visual deficit,
-dizzy,
-sudden HA with no cause
• tPA MOA -✓✓enzyme that binds to fibrin in a newly formed clot and
directly converts plasminogen to plasmin
• When can I use tPA? -✓✓ischemic stroke presenting within <3 hrs
and CT head negative
• Dosing of tPA -✓✓-*0.9 mg/kg IV*,
-max dose of *90 mg*.
-10% administered as bolus with rest infused over next 60 minutes
• How do you treat high BP with stroke? -✓✓-Nitroprusside (short half
life, easy to titrate) or IV labetalol
• What do you use for anticoagulation/antiplatelet therapy in stroke? -
✓✓ASA (not in hemorrhagic), heparin for thrombosis
,• What do you do differently to treat hemorrhagic stroke? -✓✓Give
prophylactic anticonvulsant like phenytoin because of increased seizure
risk, antiplatelet therapy contraindicated
• Ischemic stroke is the most common type (87%) and has what signs
and symptoms? -✓✓No headache, not visible on CT without contrast
until 6 hours post stroke
• What are the types of Ischemic Stroke? -✓✓1. Thrombotic: narrowing
of damaged vascular lumen by an in situ process, usually clot.
2. Embolic (20%): obstruction of normal vascular lumen by
intravascular material from remote source
• Types of Hemorrhagic Stroke -✓✓1. Intracerebral (10%): results from
rupture of small arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into
subarachnoid space)
• Causes of Intracerebral hemorrhagic stroke are what? -✓✓HTN,
amyloidosis, iatrogenic anticoagulation, vascular malformations, cocaine
use
• Causes of Subarachnoid hemorrhagic stroke are what? -✓✓berry
aneurysm rupture, vascular malformation rupture
• Signs and symptoms of Intracerebral hemorrhagic stroke are what? -
✓✓ICP rises, vasoconstriction-sweating
• Signs and symptoms of Subarachnoid hemorrhagic stroke are what? -
✓✓may be preceded by warning headache, neck/back pain, "worst
headache of my life," thunderclap, may have loss of consciousness
,• Treatment of Subarachnoid hemorrhage -✓✓surgery, control
hypertension, analgesics
• What is the name for the disease that beings following an operation, a
fracture, or vascular event such as stroke or heart attack? -✓✓Complex
regional pain syndrome (CRPS)
• Signs and symptoms of complex regional pain syndrome are what? -
✓✓regional pain in affected limb, restricted mobility, edema, color
changes of skin, spotty bone thinning. Hallmark is severe burning or
throbbing pain with associated allodynia in affected extremity.
• Treatment for complex regional pain syndrome -✓✓Amitriptyline,
nortriptyline, gabapentin, pregabalin, lamotrigine; NSAIDs; Calcitonin
to reduce pain as adjunctive therapy; Bisphosphonates, IVIG, regional
nerve blocks, dorsal column stimulation
• _____ accounts for 75% of nontraumatic cases of subarachnoid
hemorrhage. -✓✓berry aneurysm
• Imaging modality used to diagnose Subarachnoid Hemorrhage? -✓✓-
CT without contrast
-If CT negative but still suspect SAH, do LP to look for RBC or
xanthochromia (will not develop until 12hrs after onset)
• Delirium -✓✓transient disorder characterized by impaired attention,
perception, memory and cognition. Sleep wake cycles interrupted
("sundowning"). Reduced alertness, activity levels change rapidly.
• Treatment of Delirium -✓✓treat underlying cause, Haloperidol 5-
10mg for agitation, Lorazepam 0.5-2 mg
, • Dementia -✓✓Loss of mental capacity. Psychosocial level and
cognitive abilities deteriorate and behavioral problems develop. Largest
categories are Alzheimer dz and vascular dementia. Hallucinations,
delusion, depression, repetitive behavior are common.
• Treatment of Dementia -✓✓Antipsychotics to manage psychosis
• GCS -✓✓
• Essential tremor does not occur at rest, occurs bilaterally, and has no
indication of other neuro signs. How do you treat essential tremor? -
✓✓Propranolol, Primidone (can combine these 2 if needed)
• Guillian Barre Syndrome -✓✓Idiopathic polyneuropathy often
following minor infections, immunizations or surgical procedures. Most
times no cause is identified.
• How long does Guillian Barre Syndrome last? -✓✓worst at 2-4 weeks
after onset, plateaus next 2-4 weeks, remits weeks-moats
• Signs and symptoms of Guillian Barre Syndrome -✓✓ascending
symmetric weakness and loss of DTR's, proximal muscles affected more
than distal. Sensory abnormalities, pain, tachycardia, sweating, impaired
pulmonary function, paralytic ileus
• How do you diagnose Guillian Barre? -✓✓no fever at onset, CSF
protein >45 and low WBC, MRI shows selective enhancement of
anterior spinal nerve roots
• Treatment of Guillian Barre Syndrome -✓✓IVIG or plasmapheresis,
may need intubation. Hospitalized pt with close monitoring. Recovery is
slow but approximately 60% make full recovery within 1 year.
2026 Question and Answer | Real
Questions and Answers | A+ Verified
• Define stroke -✓✓any disease process that interrupts blood flow to the
brain. can be ischemic or hemorrhagic
• gold standard diagnostic test for stroke -✓✓CT angiogram
• S/sx of a stroke -✓✓-sudden numbness/weakness,
-sudden confusion/aphasia,
-memory deficit,
-visual deficit,
-dizzy,
-sudden HA with no cause
• tPA MOA -✓✓enzyme that binds to fibrin in a newly formed clot and
directly converts plasminogen to plasmin
• When can I use tPA? -✓✓ischemic stroke presenting within <3 hrs
and CT head negative
• Dosing of tPA -✓✓-*0.9 mg/kg IV*,
-max dose of *90 mg*.
-10% administered as bolus with rest infused over next 60 minutes
• How do you treat high BP with stroke? -✓✓-Nitroprusside (short half
life, easy to titrate) or IV labetalol
• What do you use for anticoagulation/antiplatelet therapy in stroke? -
✓✓ASA (not in hemorrhagic), heparin for thrombosis
,• What do you do differently to treat hemorrhagic stroke? -✓✓Give
prophylactic anticonvulsant like phenytoin because of increased seizure
risk, antiplatelet therapy contraindicated
• Ischemic stroke is the most common type (87%) and has what signs
and symptoms? -✓✓No headache, not visible on CT without contrast
until 6 hours post stroke
• What are the types of Ischemic Stroke? -✓✓1. Thrombotic: narrowing
of damaged vascular lumen by an in situ process, usually clot.
2. Embolic (20%): obstruction of normal vascular lumen by
intravascular material from remote source
• Types of Hemorrhagic Stroke -✓✓1. Intracerebral (10%): results from
rupture of small arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into
subarachnoid space)
• Causes of Intracerebral hemorrhagic stroke are what? -✓✓HTN,
amyloidosis, iatrogenic anticoagulation, vascular malformations, cocaine
use
• Causes of Subarachnoid hemorrhagic stroke are what? -✓✓berry
aneurysm rupture, vascular malformation rupture
• Signs and symptoms of Intracerebral hemorrhagic stroke are what? -
✓✓ICP rises, vasoconstriction-sweating
• Signs and symptoms of Subarachnoid hemorrhagic stroke are what? -
✓✓may be preceded by warning headache, neck/back pain, "worst
headache of my life," thunderclap, may have loss of consciousness
,• Treatment of Subarachnoid hemorrhage -✓✓surgery, control
hypertension, analgesics
• What is the name for the disease that beings following an operation, a
fracture, or vascular event such as stroke or heart attack? -✓✓Complex
regional pain syndrome (CRPS)
• Signs and symptoms of complex regional pain syndrome are what? -
✓✓regional pain in affected limb, restricted mobility, edema, color
changes of skin, spotty bone thinning. Hallmark is severe burning or
throbbing pain with associated allodynia in affected extremity.
• Treatment for complex regional pain syndrome -✓✓Amitriptyline,
nortriptyline, gabapentin, pregabalin, lamotrigine; NSAIDs; Calcitonin
to reduce pain as adjunctive therapy; Bisphosphonates, IVIG, regional
nerve blocks, dorsal column stimulation
• _____ accounts for 75% of nontraumatic cases of subarachnoid
hemorrhage. -✓✓berry aneurysm
• Imaging modality used to diagnose Subarachnoid Hemorrhage? -✓✓-
CT without contrast
-If CT negative but still suspect SAH, do LP to look for RBC or
xanthochromia (will not develop until 12hrs after onset)
• Delirium -✓✓transient disorder characterized by impaired attention,
perception, memory and cognition. Sleep wake cycles interrupted
("sundowning"). Reduced alertness, activity levels change rapidly.
• Treatment of Delirium -✓✓treat underlying cause, Haloperidol 5-
10mg for agitation, Lorazepam 0.5-2 mg
, • Dementia -✓✓Loss of mental capacity. Psychosocial level and
cognitive abilities deteriorate and behavioral problems develop. Largest
categories are Alzheimer dz and vascular dementia. Hallucinations,
delusion, depression, repetitive behavior are common.
• Treatment of Dementia -✓✓Antipsychotics to manage psychosis
• GCS -✓✓
• Essential tremor does not occur at rest, occurs bilaterally, and has no
indication of other neuro signs. How do you treat essential tremor? -
✓✓Propranolol, Primidone (can combine these 2 if needed)
• Guillian Barre Syndrome -✓✓Idiopathic polyneuropathy often
following minor infections, immunizations or surgical procedures. Most
times no cause is identified.
• How long does Guillian Barre Syndrome last? -✓✓worst at 2-4 weeks
after onset, plateaus next 2-4 weeks, remits weeks-moats
• Signs and symptoms of Guillian Barre Syndrome -✓✓ascending
symmetric weakness and loss of DTR's, proximal muscles affected more
than distal. Sensory abnormalities, pain, tachycardia, sweating, impaired
pulmonary function, paralytic ileus
• How do you diagnose Guillian Barre? -✓✓no fever at onset, CSF
protein >45 and low WBC, MRI shows selective enhancement of
anterior spinal nerve roots
• Treatment of Guillian Barre Syndrome -✓✓IVIG or plasmapheresis,
may need intubation. Hospitalized pt with close monitoring. Recovery is
slow but approximately 60% make full recovery within 1 year.
