Dizzy Spells

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Question 1 of 3

1. Question
You perform HINTS examination. What results will indicate the patient may be having a posterior circulation stroke?
- Head impulse is not preserved, nystagmus is horizontal and vertical alignment of eye is preserved.
- Head impulse is preserved, Nystagmus is vertical and vertical alignment of eyes is preserved.
- Head impulse is preserved, nystagmus is vertical and horizontal, vertical skew is present.
- Head impulse is not preserved, Nystagmus is horizontal and Dix hall-pike test is positive.
- Head impulse is preserved and Dix Hall pike is positive.
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Question 2 of 3

2. Question
What are the most appropriate next ED management steps for this patient?
- Run a stroke call, give aspirin, book a CT head
- Perform Blood glucose, run a stroke call, book a CT head with Angio
- Run a stroke call, book a CT head, administer IV ondansetron
- Perform blood glucose, administer IV prochlorperazine, book a CT head
- Perform Blood glucose, book an MRI head and discuss with stroke team
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Question 3 of 3

3. Question
The CT head and angiogram confirms that the patient has an ischaemic stroke. The stroke team started thrombolysis in CT and have brought the patient to ED resus for observation. After 45 min the patient starts seizing and his GCS drops to 9.

What is the best next management step?
- Call the stroke team to manage seizures
- Stop the thrombolysis, treat the seizures and book a repeat CT head
- Continue thrombolysis and book a repeat CT head after controlling the seizures
- Treat the seizures, prepare for intubation and contact the stroke team
- Stop thrombolysis and take the patient for a repeat CT scan yourself
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Dizzy Spells

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