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BR 3rd Ed > Ch 2 - TBI: Prognosis > Flashcards

Ch 2 - TBI: Prognosis Flashcards

1
Q

Describe the motor response scores for GCS.

A 
1- None
2- Decerebrate posturing to pain
3- Decorticate posturing to pain
4- Withdraws limbs to pain
5- Localizes to pain
6- Obeys verbal commands
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2
Q

Describe the verbal response scores for GCS.

A 
1- None
2- Unitelligible sounds
3- Inappropriate words
4- Confused
5- Alert and oriented
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3
Q

Describe the eye opening scores for GCS.

A

1- None
2- Opens to pain
3- Opens to loud voice
4- Opens spontaneously

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4
Q

What is the severity of TBI based on GCS score?

A

Severe: 3 to 8
Moderate: 9 to 12
Mild: 13 to 15

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5
Q

At what GSC score is a patient considered comatose?

A

GSC <8

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6
Q

Which GCS category is the best acute predictor of outcome in TBI?

A

Best motor response

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7
Q

What is the Fronto-orbicular reflex?

A

Orbicularis oculi contraction on percussion of the glabella

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8
Q

What is the Oculocardiac reflex?

A

Bradycardia induced by increasing pressure on the eyeball

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9
Q

Describe the relationship between length of coma and disability.

A

Coma <2 weeks: Severe disability unlikely

Coma >4 weeks: Good recovery unlikely

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10
Q

When does the resolution of Posttraumatic amnesia (PTA) occur?

A

Incorporation of ongoing daily events occurs in the working memory

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11
Q

Describe the relationship between length of PTA and disability.

A

PTA <2 mo: severe disability unlikely

PTA >3 mo: good recovery unlikely

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12
Q

What is the Galveston Orientation and Amnesia Test (GOAT)?

A

Structured interview that quantifies the patient’s orientation and recall of recent events to assess PTA

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13
Q

What score on GOAT defines the end of PTA?

A

Score 75 or > for 2 consecutive days

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14
Q

What is the length of PTA defined by?

A

of days beginning at the end of the coma to the time the patient attains the first of two successive GOAT scores >75

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15
Q

At what GOAT score do neuropsychological assessments become productive?

A

Consistent scores >70

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16
Q

What is the severity of TBI based on duration of PTA?

A 
Very mild: <5 min
Mild: 5-60 min
Moderate: 1-24 hr
Severe: 1-7 days
Very severe: 1-4 weeks
Extremely severe: >4 weeks
17
Q

How does age affect TBI prognosis?

A

Higher mortality: <5 yo and >65 yo

Children and young adults have more positive prognosis

18
Q

Which parts of the eye exam indicate good prognosis in TBI?

A

Reactive pupils

Conjugate eye movement

19
Q

What period does most recovery happen after TBI?

A

First 6 months post-injury

20
Q

Which posturing has a better prognosis?

A

Decorticate>decerebrate or flaccid tone

21
Q

What is the disability rating score?

A

30-point scale of 8 dimensions developed specifically for brain injury providing quantitative index of disability

22
Q

What are the 8 dimensions of the disability rating score?

A
  1. Eye opening
  2. Verbalization/communication 3. Motor responsiveness
  3. Feeding*
  4. Toileting*
  5. Grooming*
  6. Overall level of functioning/dependence
  7. Employability
    * Measuring cognitive skills only in these categories
23
Q

What is a Rancho Los Amigos Level I?

A

No response

24
Q

What is a Rancho Los Amigos Level II?

A

Generalized response to stimulation

25
Q

What is a Rancho Los Amigos Level III?

A

Localized response to stimuli

26
Q

What is a Rancho Los Amigos Level IV?

A

Confused and agitated behavior

27
Q

What is a Rancho Los Amigos Level V?

A

Confused with inappropriate behavior (non-agitated)

28
Q

What is a Rancho Los Amigos Level VI?

A

Confused but appropriate behavior

29
Q

What is a Rancho Los Amigos Level VII?

A

Automatic and appropriate behavior

30
Q

What is a Rancho Los Amigos Level VIII?

A

Purposeful and appropriate behavior

31
Q

What are the categories of Functional Independence Measure (FIM)?

A 
Self care
Sphincter control
Mobility
Communication
Psychosocial adjustment
Cognitive function
32
Q

What are the level of function scoring of Functional Independence Measure (FIM)?

A 
7- Complete independent
6- Modified Independent
5- Supervision
4- Minimal assist
3- Moderate assist
2- Maximal assist
1- Total Assist
33
Q

What is the Halstead–Reitan Neuropsychological Battery (HRNB)?

A

Diagnostic test to assess for brain damage location prior to CT scans

34
Q

What is the Wechsler Adult Intelligence Scale-Revised (WAIS–R) used for?

A

Most frequently used measure of general IQ

35
Q

What is Minnesota Multiphasic Personality Inventory (MMPI)?

A

550 true/false questions that

yield information about aspects of personality

36
Q

Which test has a 90% sensitivity for diagnosing aphasia?

A

Token test

37
Q

What is the Token test?

A

Increasingly complex oral commands laid out horizontally to test auditory comprehension and language production

BR 3rd Ed (92 decks)

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