Midterm

Question 1

What sport is most commonly associated with the highest risk of concussion?
A. Soccer
B. Baseball
C. Lacrosse
D. Football

Answer 1

D. Football

Question 2

The domains of concussion symptoms include all of the following except EXCEPT:
A. Sleep
B. Physical
C. Emotional
D. Nutrition
E. Cognitive

Answer 2

D. Nutrition

Question 3

Which of the following is a potential consequence of increased neuronal calcium influx following a concussion?
A. Cell death (apoptosis)
B. Dysfunction and disruption of axonal neurofilaments and microtubules
C. Mitochondrial dysfunction
D. All of the above

Answer 3

D. All of the above

Question 4

How many people sustain a TBI yearly?
A. 2.5million
B. 1.7million
C. 8.1million
D. 1million

Answer 4

B. 1.7million

Question 5

The most current biomechanical theory of concussion and brain injury is:
A. Neurometabolic cascade
B. Coup-countercoup phenomenon
C. Military concussion
D. Second impact syndrome

Answer 5

B. Coup-countercoup phenomenon

Question 6

After diagnosing an athlete with a concussion, what should you NOT do.
A. Perform serial exams
B. Monitor vitals
C. Leave the athlete alone
D. Monitor deterioration

Answer 6

C. Leave the athlete alone

Question 7

Historians now believe King Henry VIII may have become the crazy tyrant he was because of the long term effects of multiple sports concussions and the presence of post concussion syndrome of CTE.
A. True
B. False

Answer 7

A. True

Question 8

1 in 5 high school athletes will sustain a concussion during the season.
A. True
B. False

Answer 8

A. True

Question 9

Shearing forces the cause transverse axons to stretch, tear, or seperate from the cell bodies describes?
A. Neurometabolic cascade
B. Axonal shearing
C. Coup-countercoup
D. Cell degeneration

Answer 9

B. Axonal shearing

Question 10

Symptoms of a concussion are largely due to transient functional disturbances of neuronal and parenchymal cells rather than frank neuronal destruction.
A. True
B. False

Answer 10

A. True

Question 11

Within the Neurometabolic cascade, potassium (K+) leaves the cell, while _______ rushes into the cell.
A. Calcium (Ca++)
B. Oxygen (O2+)
C. Sodium (Na+)
D. Chloride (Cl-)

Answer 11

A. Calcium (Ca++)

Question 12

Damaged neurons in the concussed brain suffer a cellular “energy crisis” due to which of the following factors?
A. Mitochondrial dysfunction
B. Decreased cerebral blood flow
C. Cellular hypermetabolism with decreased available ATP
D. All of the above

Answer 12

D. All of the above

Question 13

The movement of the brain inside the skull during a rapid acceleration - deceleration event is referred to by what term?
A. Brain slosh
B. The Cunningham effect
C. Diffuse axonal injury
D. Coup - contrecoup

Answer 13

A. Brain slosh

Question 14

What is it called when a head impact causes the brain to move back and forth within the skull causing an injury to the brain at both the site of impact and a location opposite the site of impact?
A.diffuse axonal injury
B. Neurometabolic cascade
C. Double concussion
D. Coup - contrecoup effect

Answer 14

D. Coup - contrecoup effect

Question 15

What condition is defined by an uncontrollable increase in intracranial pressure caused by diffuse cerebral edema that occurs after a head impact has been sustained before complete recovery from a previous head trauma?
A. Second impact
B. Subconcussion
C. Postconcussion syndrome
D. Intraparenchymal hemorrage

Answer 15

A. Second impact

Question 16

What term best describes the condition caused by impacts that commonly occur in sports in which there are no visible signs or symptoms of neurological dysfunction but underlying injury may be present and significantly exacerbate by repeated additional impacts.
A. Subconcussion
B. Post concussion syndrome
C. Chronic encephalopathy
D. Second impact syndrome

Answer 16

A. Subconcussion

Question 17

Which of the following is the most serious clinical sequela in second impact syndrome?
A. Brain herniation
B. Headache
C. Paralysis
D. Nausea

Answer 17

A. Brain herniation

Question 18

Which of the following is a symptom of second impact syndrome?
A. Dilated pupils
B. Loss of consciousness
C. Respiratory distress
D. All of the above

Answer 18

D. All of the above

Question 19

The risk of second impact syndrome is usually greater in the younger athlete because their overall physiological susceptibility to traumatic brain injuries is greater due to their age.
A. True
B. False

Answer 19

A. True

Question 20

The reason second impact syndrome (SIS) is a more significant diagnosis than a routine concussion is because the mortality rate for SIS is around 50%
A. True
B. False

Answer 20

A. True

Question 21

Roughly 1/3 of all sports concussions occur in practice.
A. True
B. False

Answer 21

A. True

Question 22

Which of the following is NOT a symptom of second impact syndrome?
A. Pupillary miosis
B. Respiratory distress
C. Dilated pupils
D. Loss of consciousness

Answer 22

A. Pupillary miosis

Question 23

What percentage of concussions do NOT involve loss of consciousness (LOC)?
A. 75
B. 90
C. 85
D. 80

Answer 23

B. 90

Question 24

The intensity of symptoms in a concussion are NOT related to:
A. All of the above
B. Intensity of injury
C. Specific type of injury
D. Number of consecutive injuries sustained

Answer 24

A. All of the above

Question 25

Immunoexcitatory causes of damage to neuronal cell membranes, dendrites, synapses, mitochondria, and DNA. A. True B. False

Answer 25

A. True

Question 26

Symptom based grading scales have been mostly abandoned due to lack of evidence and support in the scientific community. A. True B. False

Answer 26

A. True

Question 27

Instructions to give the patient and/or guardian following a concussion diagnosis include: A. All of the above B. Do not be left alone C. Have complete physical and cognitive rest D. No driving

Answer 27

A. All of the above

Question 28

Concussion is believed to have been coined as a term in 16th century Europe. A. True B. False

Answer 28

A. True

Question 29

When was the diagnosis of concussion, as we understand it today, first documented as a clinical entity separated from traumatic head injuries when physical damage to the head is identifiable? A. In professional boxing in the early 20th century B. In ancient Persia over 1000 years ago C. In England during the late Middle Ages around 1500 AD D. None of the above

Answer 29

B. In ancient Persia over 1000 years ago

Question 30

Continuing activities that increase symptoms will DECREASE recovery time. A. True B. False

Answer 30

B. False

Question 31

What term was created around the 1920s to describe the constellation of chronic symptoms often seems in aging something sustained multiple concussions? A. Chronic traumatic brain injury B. Second impact syndrome C. Dementia pugilistica D. Mohammad Ali's disease

Answer 31

C. Dementia pugilistica

Question 32

Which of the following examinations should you perform in the ? A. Cervical MRS's B. Cranial nerve testing C. Balance testing D. All of the above

Answer 32

D. All of the above

Question 33

What is the component of many sports concussion evaluation tools that asses the athletes ability to answer the following questions: "where are you right now?" "What team are we playing?" "What quarter are we in?" Or "who did we play in the last game?" A. Memory recall evaluation B. Maddock's score C. Glasgow scale D. Red flag checklist

Answer 33

B. Maddock's score

Question 34

Who was the first to describe and diagnose the first case of chronic traumatic encephalopathy? A. Mike Webster B. Dr. William Moreau C. Jeanne Marie laskas D. Dr. Bennet omalu

Answer 34

D. Dr. Bennet omalu

Question 35

Which of the following expressions for concussions is still often used in the scientific literature and by some health care practitioners? A. Mild traumatic brain injury (mTBI) B. Brain slosh C. CTE D. Commotion cerebri

Answer 35

A. Mild traumatic brain injury (mTBI)

Question 36

What tool is used for assessing the level of consciousness of a concussed athlete? A. ACE B. Symptom evaluation table C. Glasgow scale D. Maddock's score

Answer 36

C. Glasgow scale

Question 37

In order to sustain a concussion, loss of consciousness needs to occur. A. True B. False

Answer 37

B. False

Question 38

Which of the following is the most common symptom associated with a concussion? A. Headache B. Amnesia C. Inability to concentrate D. Sleep disturbances

Answer 38

A. Headache

Question 39

A detailed concussion history is an important part of the evaluation both in the injured athlete and when conducting a pre-participation examination. A. True B. False

Answer 39

A. True

Question 40

Before any assessment of concussion can begin after an acute injury on the field, the athlete must be checked for a clear airway, cardiac function and evaluated for any spinal injuries. A. True B. False

Answer 40

A. True

Question 41

Following a concussion diagnosis, one should call their doctor or go to the ER of experiencing: A. All of the above B. Seizures C. Trouble with balance D. Increased headache

Answer 41

A. All of the above

Question 42

Most concussions (80%-90%) resolve in what period of time? A. 24-48 hours B. 7 to 10 days C. 1 month D. 48 hours - 1 week

Answer 42

B. 7 to 10 days

Question 43

There are now routine clinical tests that can assess the level of metabolic and neurochemical changes that occur in the brain after a concussion. A. True B. False

Answer 43

B. False

Question 44

Which of the following describes the condition whereby various symptoms of concussion may last for weeks or months after the initial injury? A. Chronic traumatic encephalopathy (CTE) B. Post concussion syndrome C. Second impact syndrome D. Subconcussion

Answer 44

B. Post concussion syndrome

Question 45

When an athlete sustains a mild hit to the head or body while they are still healing from a diagnosed concussion, it is possible to experience an uncontrollable spike of diffuse intracerebral edema. What is the name of the phenomenon? A. Postconcusssion syndrome B. Subconcussion C. There is no such phenomenon or diagnosis D. Second impact syndrome

Answer 45

D. Second impact syndrome

Question 46

Which of the following diagnoses is characterized by a series of low level impacts that do not cause symptoms of a clinically defined concussion but cause accumulated effects over time? A. Subconcussion B. Post concussion C. Brain contusion D. Second impact syndrome

Answer 46

A. Subconcussion

Question 47

Which of the following is NOT sign or symptom of concussion? A. Slow reaction time B. Headache C. Inability to concentrate D. None of the above (all of the above are important signs or symptoms of concussion)

Answer 47

D. None of the above (all of the above are important signs or symptoms of concussion)

Question 48

A concussion can be caused by a A. All of the above B. Bump to the body C. Blow to the head D. Jolt to the head

Answer 48

A. All of the above

Question 49

A complex disorder with variable symptoms - such as headaches, dizziness, fatigue, insomnia, irritability memory difficulties, and/or problems with concentration correctly describes A. Sub concussion B. Chronic traumatic encephalopathy C. Second impact syndrome D. Post concussion syndrome

Answer 49

D. Post concussion syndrome

Question 50

Signs and symptoms of concussion may evolve over minutes to hours. A. True B. False

Answer 50

A. True