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

The 'talk and die' phenomenon refers to patients who communicate normally after TBI but then rapidly deteriorate, classically due to an expanding epidural hematoma.

Question 2

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

Accepted Answer

Hypertension, bradycardia, and irregular respirations

Answer

Cushing's triad — hypertension (widened pulse pressure), bradycardia, and irregular respirations — signals brainstem compression and is a neurological emergency.

Question 3

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

Accepted Answer

Aggressive fever prevention; treat hyperthermia promptly

Answer

While prophylactic hypothermia is not routinely recommended, fever above 38°C must be aggressively treated because hyperthermia significantly worsens secondary brain injury.

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

The Brain Trauma Foundation identifies hypotension with SBP below 90 mmHg as a critical secondary insult that significantly worsens TBI outcomes.

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

Mannitol reduces ICP primarily through its osmotic effect, establishing a gradient that pulls water from edematous brain tissue into the bloodstream for renal elimination.

TBI - Traumatic Brain Injury Certification Practice Test

TBI - Traumatic Brain Injury Certification Practice Test

TBI TBI Acute Care & Emergency Management 2