TCRN Neurological Trauma

Question 1

A patient's GCS is calculated as: eyes open to voice (3), confused verbal response (4), localizes to pain (5). What is the total GCS score?

Accepted Answer

12

Answer

GCS = E3 + V4 + M5 = 12, indicating moderate brain injury.

Question 2

Which clinical finding is the earliest sign of increasing intracranial pressure (ICP)?

Accepted Answer

Altered level of consciousness or restlessness

Answer

Altered level of consciousness, including subtle confusion or restlessness, is the earliest and most sensitive indicator of rising ICP.

Question 3

Cushing's triad, the late sign of increased ICP, includes which three findings?

Accepted Answer

Bradycardia, hypertension, and irregular respirations

Answer

Cushing's triad—bradycardia, hypertension, and irregular respirations—is a late, ominous sign of brainstem herniation.

Question 4

A patient with a basilar skull fracture may exhibit which classic finding?

Accepted Answer

Battle's sign or raccoon eyes with possible CSF rhinorrhea or otorrhea

Answer

Basilar skull fractures classically produce periorbital or mastoid ecchymosis (raccoon eyes/Battle's sign) and possible CSF leaks.

Question 5

Which type of intracranial hematoma is associated with a lucid interval followed by rapid deterioration?

Accepted Answer

Epidural hematoma

Answer

Epidural hematoma, classically from middle meningeal artery rupture, produces a lucid interval before rapid neurological decline.

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