TBI TBI Acute Care & Emergency Management 2

Question 1

The 'talk and die' phenomenon in TBI describes patients who:

Accepted Answer

Appear neurologically intact initially then rapidly deteriorate due to expanding hematoma

Answer

Die while attempting to speak during intubation

Answer

Have preserved speech centers despite severe motor deficits

Answer

Experience fatal aspiration while talking after extubation

Question 2

Cushing's triad, indicating critically elevated intracranial pressure and impending herniation, consists of:

Accepted Answer

Hypertension, bradycardia, and irregular respirations

Answer

Hypotension, tachycardia, and fever

Answer

Hypotension, bradycardia, and apnea

Answer

Hypertension, tachycardia, and hypothermia

Question 3

What is the recommended approach to temperature management in acute severe TBI?

Accepted Answer

Aggressive fever prevention; treat hyperthermia promptly

Answer

Prophylactic induced hypothermia to 32°C for all patients

Answer

Permissive hyperthermia up to 39°C is acceptable

Answer

Temperature management is not clinically significant in TBI

Question 4

What minimum systolic blood pressure must be maintained to prevent secondary injury in acute severe TBI, per Brain Trauma Foundation guidelines?

Accepted Answer

90 mmHg

Answer

120 mmHg

Answer

70 mmHg

Answer

50 mmHg

Question 5

What is the primary mechanism by which mannitol reduces intracranial pressure in TBI?

Accepted Answer

Creating an osmotic gradient that draws water from brain tissue into the vasculature

Answer

Reducing choroid plexus CSF production

Answer

Blocking NMDA glutamate receptors to reduce excitotoxicity

Answer

Inducing direct cerebral vasoconstriction

Question 6

At what angle should the head of the bed be positioned for acute TBI patients to reduce ICP while preserving CPP?

Accepted Answer

30 degrees

Answer

0 degrees (completely flat)

Answer

15 degrees

Answer

45 degrees

Question 7

At what GCS score is intubation for airway protection typically indicated in a TBI patient?

Accepted Answer

GCS of 8 or below

Answer

GCS of 12 or below

Answer

GCS of 10 or below

Answer

GCS of 5 or below