Scenario
A 72 year old patient presents to the emergency department with acute left hemiparesis.
Question
a. Discuss the use of thrombolysis in acute stroke. (50%) b. List your differential diagnoses. (50%)
Answer
FACEM SAQ Exam 2005.1 – Question 5
- The overall pass rate for this question was 30 / 44 (68.2%).
- Pass Criteria
- The first question was expected to be answered by considering not just cerebrovascular events but also the commonly encountered stroke mimics.
- It was hoped that the listed differentials would be given some order so that clinical perspective could be demonstrated.
- It was expected that the second question would be answered with some reference to the recent literature and important clinical trials and with an acknowledgement that thrombolysis in stroke in Australasia is controversial and currently has limited utility.
- Features of unsuccessful answers
- Features of failing answers included differential diagnoses that were too limited or omitted significant conditions, failure to address both the pros and cons of thrombolysis and inadequate knowledge of the current state of research in this area.
About Mike Cadogan
