Exam 3 -- Head Trauma and Infectious and Inflammatory Disease

Question 1

True or false: traumatic brain injuries are the leading cause of death in the US for people up to the age of 45.

Answer 1

True.

Question 2

When a TBI occurs, there is axonal rupture from shear forces. What types of neurotransmitters are released in response?

Answer 2

Excitatory (glutamate, acetylcholine). This also leads to the generation of free radicals.

Question 3

What rating scale, from 0 to 15, is used to rank a patient’s TBI symptoms and decide whether or not they need an ER visit?

Answer 3

Glasgow Coma Scale

Question 4

What is the name for an area of cerebral bruising with localized edema?

Answer 4

Contusion. This is the most common finding of a TBI.

Question 5

What factors can help in determining when to do CT imaging for a TBI?

Answer 5

Less than 15 Glasgow score
Vomiting
Over age 65
Amnesia for more than 30 minutes
Seizures
Anticoagulant use
Alcohol use

Question 6

Comparing subdural vs epidural hematomas, which is located between the skull and the dura?

Answer 6

Epidural

Question 7

Comparing subdural vs epidural hematomas, which is located between the dura and the arachnoid?

Answer 7

Subdural

Question 8

Comparing subdural vs epidural hematomas, which involves the venous blood supply?

Answer 8

Subdural

Question 9

Comparing subdural vs epidural hematomas, which involves the arterial blood supply?

Answer 9

Epidural

Question 10

Comparing subdural vs epidural hematomas, which has a more acute onset?

Answer 10

Epidural

Question 11

Comparing subdural vs epidural hematomas, which has a slower onset?

Answer 11

Subdural

Question 12

Comparing subdural vs epidural hematomas, which has a lenticular shape on a CT scan?

Answer 12

Epidural

Question 13

Comparing subdural vs epidural hematomas, which has a lunar shape on a CT scan?

Answer 13

Subdural

Question 14

Comparing subdural vs epidural hematomas, which has the worse prognosis?

Answer 14

Subdural

Question 15

Which type of TBI is the most severe?

Answer 15

Diffuse axonal injury

Question 16

True or false: damage due to diffuse axonal injury is not as bad as it looks on imaging.

Answer 16

False; it is worse than appears on imaging.

Question 17

Chronic traumatic encephalopathy is when repeated concussions cause cumulative neurologic defects, including an increase in risk for Alzheimer’s.

Answer 17

Free card.

Question 18

What is the survival rate of patients with bacterial meningitis?

Answer 18

25%

Question 19

What is the most common cause of bacterial meningitis?

Answer 19

Strep. Pneumoniae

Question 20

What clinical findings might a patient with bacterial meningitis have?

Answer 20

Fever, HA/altered mental status, and nuchal rigidity

Question 21

If you performed a lumbar puncture on a patient with bacterial meningitis, what might you find?

Answer 21

Elevated opening pressure, elevated WBCs

Question 22

How would you treat bacterial meningitis?

Answer 22

IV vancomyin with ceftriaxone

Question 23

What are some viral causes of aspectic meningitis?

Answer 23

Enterovirus, herpes simplex, HIV, WNV, herpes zoster, mumps

Question 24

What are some fungal causes of aspectic meningitis?

Answer 24

Hisoplasm, candida

Question 25

What are some parasitic causes of aspectic meningitis?

Answer 25

Lyme

Question 26

What are some non-infectious causes of aspectic meningitis?

Answer 26

Lupus

Question 27

Encephalitis has more severe brain function abnormalities than meningitis.

Answer 27

Free card.

Question 28

What is the cause of most cases of encephalitis?

Answer 28

Viral (usually herpes simplex)

Question 29

True or false: encephalitis has a better survival rate than meningitis.

Answer 29

True.