TBI Flashcards

1
Q

injury that occurs at the time of trauma

A

TBI primary injury

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2
Q

what is the pathogenesis of TBI primary injuries?

A

diffuse axonal injury d/t coup and counter-coup

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3
Q

injury that is initiated at the time of initial trauma and continues for hours or days

A

TBI secondary injury

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4
Q

what does TBI secondary injury lead to? (3)

A

neuron death
cerebral edema
increase ICP

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5
Q

what kind of injuries will result in greater axonal damage? (2)

A

assault
falling object

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6
Q

unable to remember things that happened after the injury

A

anterograde amnesia

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7
Q

unable to remember what happened right before the injury

A

retrograde amnesia

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8
Q

a patient opens their eyes when spoken to, can have a conversation but is disoriented, and makes withdrawal movements to pain. what is their GCS?

A

11

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9
Q

a patient opens their eyes when you walk in the room, grunts, and follows motor commands. what is their GCS?

A

12

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10
Q

a patient only opens their eyes when you pinch their skin, says inappropriate words, and uses extensor posturing to pain. what is their GCS?

A

7

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11
Q

what is the classification of TBI if GCS is 13-15?

A

mild

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12
Q

what is the classification of TBI if LOC is over 30 mins and GCS is 9-12?

A

moderate

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13
Q

what is the classification of TBI if LOC is over 24 hours and GCS is 3-8?

A

severe

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14
Q

in which patients is hospital admission recommended? (4)

A

GCS < 15
abnormal CT
seizures
underlying coagulopathy

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15
Q

what is the management for moderate/severe TBIs? (3)

A

monitor for ischemia, cerebral edema, increased ICP
monitor for coagulopathy (PT/INR)
monitor for seizures (EEG)

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16
Q

what can we give for increased ICP in moderate/severe TBI? (2)

A

mannitol
normal saline
elevate head of bed

17
Q

what should be avoided in patients with moderate/severe TBI?

A

glucocorticoids

18
Q

what is the hallmark of concussions/mild TBIs? (3)

A

confusion
amnesia
+/- loss of consciousness

19
Q

according to the AAN, what is classified as a grade 3 or severe concussion/mild TBI?

A

loss of consciousness

20
Q

according to the AAN, what is classified as a grade 2 or moderate concussion/mild TBI?

A

symptoms that last over 15 mins

21
Q

when is a recurrent concussion more likely to occur?

A

within 10 days after a prior concussion

22
Q

what is not necessary in sports-related concussions to be diagnosed?

A

CT imaging

23
Q

what is the management for mild TBI/concussion? (3)

A

cognitive and physical rest
NSAIDs for pain
follow up

24
Q

what is the return to play precaution for a concussion?

A

patient must be asymptomatic without medication