Stroke: case definition in surveys: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Stroke: case definition in surveys

Sample item

A community survey uses the WHO definition of stroke. Which person would be counted as a stroke case?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Sudden left hemiparesis and facial droop lasting 36 hours before improving

The WHO definition of stroke is rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin. Episodes resolving within 24 hours are classed as transient ischaemic attacks.

Option by option

  • A. Sudden unilateral weakness lasting 18 hours and resolving completely

    Resolution within 18 hours is under the 24-hour threshold, so it is a transient ischaemic attack.

  • B. Transient monocular blindness lasting 10 minutes

    Transient monocular blindness (amaurosis fugax) of minutes is a transient ischaemic attack.

  • C. Sudden left hand weakness that resolved fully in 3 hours

    A complete recovery in 3 hours is a transient ischaemic attack.

  • D. Sudden left hemiparesis and facial droop lasting 36 hours before improving (correct)

    Correct. Focal deficit lasting beyond 24 hours meets the definition.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, Sudden left hemiparesis and facial droop lasting 36 hours before improving. The WHO definition of stroke is rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.

Why is "Sudden unilateral weakness lasting 18 hours and resolving completely" not the answer?

Resolution within 18 hours is under the 24-hour threshold, so it is a transient ischaemic attack.

Why is "Transient monocular blindness lasting 10 minutes" not the answer?

Transient monocular blindness (amaurosis fugax) of minutes is a transient ischaemic attack.

Why is "Sudden left hand weakness that resolved fully in 3 hours" not the answer?

A complete recovery in 3 hours is a transient ischaemic attack.

What concept does this question test?

It tests Stroke: case definition in surveys in PSM. Episodes resolving within 24 hours are classed as transient ischaemic attacks.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Stroke: case definition in surveys?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.