American Board of Internal Medicine (ABIM) Certification Practice Exam

When should patients with a first TIA be hospitalized according to the National Stroke Association?

1. If symptoms last longer than 30 minutes

2. If symptoms last longer than 1 hour

3. If symptoms last longer than 2 hours

4. If symptoms last longer than 24 hours

The correct answer is: If symptoms last longer than 1 hour

Hospitalization for patients experiencing a first transient ischemic attack (TIA) is recommended if their symptoms persist longer than 1 hour. This guideline stems from the understanding that TIAs are often a precursor to a more significant stroke, and the risk factors associated with longer-lasting symptoms indicate a heightened risk of impending stroke. Symptoms lasting longer than 1 hour suggest a greater degree of vascular compromise and are indicative of a potential need for further evaluation and management to prevent subsequent cerebrovascular events. In cases where symptoms resolve quickly, such as under 1 hour, the urgency of hospitalization may be lower, as the likelihood of acute interventions being necessary is diminished. While a duration longer than 30 minutes does indicate the need for precautionary measures, it is the 1-hour mark that is typically emphasized in clinical practice guidelines. Symptoms lasting beyond 2 hours or 24 hours would typically indicate a more serious concern that may already be categorized as a stroke rather than a TIA, altering the approach and nature of the required care and interventions.