CBIS Assessment and Diagnosis 2 — Questions and Answers
Question 1: Which neuroimaging technique is most sensitive for detecting diffuse axonal injury (DAI) in the acute phase of TBI?
- CT scan
- MRI with susceptibility-weighted imaging (SWI) (Correct answer)
- Standard T1-weighted MRI
- X-ray
Correct answer: MRI with susceptibility-weighted imaging (SWI)
SWI MRI detects microhemorrhages and axonal shear injury far better than CT or standard MRI sequences.
Question 2: A patient scores a 3 on each component of the Glasgow Coma Scale (GCS). What does this total score indicate?
- Mild TBI
- Moderate TBI
- Severe TBI (Correct answer)
- Vegetative state
Correct answer: Severe TBI
A GCS score of 3 (the minimum possible) indicates severe TBI with no eye opening, no verbal response, and no motor response.
Question 3: When assessing post-traumatic amnesia (PTA), the Galveston Orientation and Amnesia Test (GOAT) considers a patient out of PTA at what minimum score?
- 55
- 65
- 75 (Correct answer)
- 85
Correct answer: 75
A GOAT score of 75 or higher on two consecutive assessments is the standard criterion for emergence from PTA.
Question 4: Which cranial nerve is most commonly injured in basilar skull fractures involving the anterior fossa, leading to anosmia?
- Cranial nerve II (optic)
- Cranial nerve I (olfactory) (Correct answer)
- Cranial nerve VII (facial)
- Cranial nerve III (oculomotor)
Correct answer: Cranial nerve I (olfactory)
The olfactory nerve (CN I) passes through the cribriform plate and is frequently sheared in anterior fossa fractures.
Question 5: The Rancho Los Amigos Levels of Cognitive Functioning Scale (LCFS) Level IV is best characterized by which behavior?
- Purposeful and appropriate responses to familiar tasks
- Confused and agitated responses to environment (Correct answer)
- No response to stimuli
- Oriented and follows simple commands consistently
Correct answer: Confused and agitated responses to environment
LCFS Level IV is the 'confused-agitated' stage, where patients are in heightened arousal and may be combative.
Question 6: A CBIS specialist administers the Disability Rating Scale (DRS). Which domain is NOT assessed by the DRS?
- Arousability
- Language function (Correct answer)
- Cognitive ability for self-care
- Level of functioning
Correct answer: Language function
The DRS measures arousability, cognitive ability for self-care, dependability level of functioning, and employability—not language function specifically.
Question 7: Which finding on neuropsychological testing is most characteristic of injury to the prefrontal cortex following TBI?
- Anterograde amnesia
- Impaired executive function and perseveration (Correct answer)
- Hemispatial neglect
- Wernicke's aphasia
Correct answer: Impaired executive function and perseveration
Prefrontal cortex damage typically produces impaired executive function including planning, inhibition, and perseveration.
CBIS Assessment and Diagnosis 2
Which neuroimaging technique is most sensitive for detecting diffuse axonal injury (DAI) in the acute phase of TBI?