Question

the emt is called to a residence for a 67-year-old patient that suddenly stopped talking, wouldn’t respond, and had a blank stare on his face. upon arrival, the emt finds the patient is alert, oriented, and responding to all questions appropriately. the bp is 136/88 mmhg, p 84/minute, r 18/minute with good chest rise, and the spo₂ is 95% on room air. which of the following conditions should the emt most strongly suspect? transient ischemic attack bipolar disorder ischemic stroke psychogenic coma generalized absence seizure

Explanation:

1. Analyze each option:

• Transient ischemic attack (TIA): TIAs cause temporary neurological symptoms (like sudden confusion, speech issues) that resolve quickly (usually within an hour, often less). The patient had a sudden episode of unresponsiveness/staring that resolved, and now has normal vitals and mental status. This fits TIA’s transient nature.
• Bipolar disorder: Manifests as mood swings (depression/mania), not sudden, brief neurological episodes with full recovery. Irrelevant here.
• Ischemic stroke: Causes persistent neurological deficits (unless treated, but symptoms don’t resolve spontaneously in minutes/hours like TIA; this patient recovered fully, so stroke is less likely).
• Psychogenic coma: Involves psychological factors, but the patient is now alert/oriented. The episode was brief and neurological, not psychogenic.
• Generalized absence seizure: Typically in children, causes brief staring (petit mal) but less common in 67yo, and recovery is immediate but context (elderly, vascular risk) favors TIA over seizure here.

1. Conclude: The sudden, brief neurological episode with full recovery matches TIA’s profile.

Answer:

A. Transient ischemic attack