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CAISS Certification Study Guide Exam
with Complete Solutions
"Blast" and inhalation injuries in the chest are coded to which organ? - ANSWER-lungs "Burst" fractures are coded to which portion of the vertebra? - ANSWER-body "Closed cisterns" implies what type of brain injury? - ANSWER-swelling "GSW to abdomen" with no further description would be coded to External or Abdominal ISS body region? - ANSWER-Abdominal "Incomplete transection" vessel injuries are coded as what in AIS? - ANSWER- incomplete circumferential involvement "Whiplash" is what type of cervical injury? - ANSWER-strain (T/F) A "crush" injury to the thoracic region must be bilateral in nature? - ANSWER- TRUE (T/F) A muscle tear, rupture, or avulsion is also known as a laceration. - ANSWER- TRUE (T/F) A partial articular acetabulum fracture may involve one or both columns? - ANSWER-TRUE (T/F) A subgaleal hematoma lies over the skull but under the scalp. - ANSWER-TRUE (T/F) A vessel puncture or perforation is also known as a laceration. - ANSWER-TRUE (T/F) Abdominal compartment syndrome is a sequela of abdominal trauma and is therefore NOT coded. - ANSWER-TRUE (T/F) Air embolus and tamponade are codeable sequela in the chest ISS region. - ANSWER-TRUE (T/F) Bilateral acetabulum fractures are coded separately. - ANSWER-TRUE (T/F) Bilateral injures of kidneys, eyes, ears, and extremities are typically codes as separate injuries (with some exceptions). - ANSWER-TRUE (T/F) Bilateral pelvic ring structures are coded separately. - ANSWER-FALSE
(T/F) Brain edema accompanying a contusion or hematoma is considered part of the lesion when assessing its size. - ANSWER-TRUE (T/F) Certain findings such as IVH, SAH, SPH, and ischemic brain damager are ALWAYS coded separately from DAI. - ANSWER-FALSE (T/F) Closed and NFS fractures share the same 7 digit AIS numerical identifier. - ANSWER-TRUE (T/F) Coma is included in each and every codable head injury. - ANSWER-FALSE (T/F) Cord injuries and vertebral fractures are coded as separate injuries. - ANSWER- FALSE (T/F) Degloving injuries may be open or closed. - ANSWER-TRUE (T/F) Fetal demise as a result of abdominal injury is a codeable AIS injury. - ANSWER- FALSE (T/F) If multiple fractures to a single bone exist but are not specified as to location, they are coded as a single injury. - ANSWER-TRUE (T/F) If OIS grading descriptions are NOT available and no other descriptors are mentioned, it is acceptable to use the terms "minor, major, or massive" as severity descriptors of solid organ injuries. - ANSWER-TRUE (T/F) In order to assign an AIS code with "blood loss > 20%" you must know to what area of the body the blood loss is linked. - ANSWER-TRUE (T/F) In the spine, dislocation and subluxation are synonymous. - ANSWER-TRUE (T/F) Multiple fractures to the same bone but in different areas are coded separately. - ANSWER-TRUE (T/F) Pelvic bones are coded to the abdominal ISS body region. - ANSWER-FALSE (T/F) Rib fractures with underlying injuries such as a lung contusion or laceration should be coded as one single injury combined. - ANSWER-FALSE (T/F) Separate vertebral fractures should be combined when no associated spinal cord injury is present. - ANSWER-FALSE (T/F) Sequela of spinal cord injuries such as transient neurological signs, incomplete cord syndromes, and complete cord syndromes are not codable injuries. - ANSWER- FALSE
A penetrating injury to the face w/ massive destruction is coded under what ISS body region? - ANSWER-Face A penetrating injury to the skull is coded under what ISS body region? - ANSWER- Head/Neck A pyramidal facial disjunction is known as what type of LeFort Fx? - ANSWER-LeFort II A rubbed or scraped area on skin or mucous membranes caused by contact with a rough surface that removes layers is known as what? - ANSWER-abrasion A simple fracture is considered open or closed? - ANSWER-closed A single vertebra that sustains more than one fracture should be coded separately or combined? - ANSWER-combined A transverse horizontal maxillary alveolar fracture, or palate facial disjunction (Guerin) is known as what type of LeFort Fx? - ANSWER-LeFort I A vertebral fracture described as "lateral mass" should be coded to which portion of the vertebra? - ANSWER-pedicle AIS is based on what three (3) factors? - ANSWER-1) anatomically- based
- consensus driven
- global AIS reflects severity of single injuries and are unaffected by what three things? - ANSWER-1) time
- sequela
- outcome AIS single digit severity codes are based on what type of patient? - ANSWER-Average An articular fracture involves what structure? - ANSWER-JOINT Anterior, central, and lateral (Brown-Sequard) cord syndromes are classified as what type of overall cord syndrome? - ANSWER-incomplete Approximately how many injury descriptors are included in AIS? - ANSWER- Are "clinical rib fxs" coded? - ANSWER-NO (must have radiology/OR/autopsy) Are all AIS data comparable from year to year? - ANSWER-NO (updates)
Are all clinical dx alone codeable? - ANSWER-NO (some require radiologic/autopsy findings) Are all injuries within the same AIS code strictly compatible? - ANSWER-NO (tibia fx & alveolar ridge are both AIS - 2, although one may be worse than the other, both are considered 'moderate') Are bilateral injures to the eyes and ears usually coded combined or separately? - ANSWER-separate Are branches of vessels coded as separate injuries? - ANSWER-NO (unless named/listed in descriptor) Are burns coded separately from burn amputations they cause? - ANSWER-NO Are complications coded as injuries? - ANSWER-NO Are complications or sequela included in the definition of an injury? - ANSWER-NO Are cord lesions and vertebral fxs coded separately? - ANSWER-NO Are degloving injuries to extremities coded to the extremity or external ISS body region?
- ANSWER-external Are dimensions of lesions used to determine injury severity? - ANSWER-YES Are entry/exit wounds reflected in the severity of internal organ/structure injuries? - ANSWER-YES Are external injuries coded independent of their body region? - ANSWER-YES Are injury etiologies (causes) related to AIS injury scores? - ANSWER-NO Are preliminary (suspected, possible, rule out) dx codeable? - ANSWER-NO Are sequela or outcomes coded as injuries? - ANSWER-NO Asphyxia is assigned to which ISS region? - ANSWER-Head and Neck Asphyxia/suffocation is assigned to which ISS body region? - ANSWER-Head Assigning injuries to too few body regions results in what? - ANSWER-underestimation of ISS
Can lung contusions be coded on the bases of pulmonary dysfunction alone? - ANSWER-NO Can more than three regions be used to calculate an ISS? - ANSWER-NO Can patient or bystander reports of LOC be used for coding purposes? - ANSWER-NO Can the GCS be used as an indication of LOC for coding purposes? - ANSWER-NO Can you have more than one type LeFort fracture? - ANSWER-YES (one on each side) Caustic agent ingestion injuries are coded to which ISS body region? - ANSWER- specific organ injured Caustic agent inhalation injuries are assigned to which ISS body region? - ANSWER- Chest Cervical spinal injuries are assigned to which ISS body region? - ANSWER-Head/Neck Complete separation of a joint is known as what type of injury? - ANSWER-dislocation Concussion and DAI are considered focal or diffuse brain injuries? - ANSWER-diffuse Cranial nerve contusion is coded when there is what documented? - ANSWER- weakness/paresthesia subtotal loss of function Cranial nerve laceration is coded when what is documented? - ANSWER-paralysis/total loss of function DAI (diffuse axonal injuries) are also know as what type of injury? - ANSWER-white matter shearing Define injury? - ANSWER-Anatomic lesion resulting from transfer of injury. Do all ISS scores have the same mortality rates? - ANSWER-NO (depends on body regions affected) Do multiple rib fxs NFS have a specific AIS code? - ANSWER-YES Do patients with an AIS 9 achieve an accurate ISS score? - ANSWER-NO Does a linear relationship exist between AIS severity codes? - ANSWER-NO (AIS 4 is more, NOT twice as severe as AIS 2)
Does AIS assess the severity of multiple injuries? - ANSWER-NO (single injury severity only) Does fracture displacement affect the severity of an injury for AIS coding purposes? - ANSWER-NO Drowning is assigned to which ISS body region? - ANSWER-Chest Drowning is assigned to which ISS region? - ANSWER-Chest Ecchymosis, subcutaneous hematoma, bruise, and bump are all considered what type of external injury? - ANSWER-contusions For a complete articular acetabulum fracture to exist, separation of the attachment between the articular surface and the posterior _____________ must occur. - ANSWER-ilium Fractures may be best described in what type of report? - ANSWER-radiology Frostbite is assigned to which ISS body region? - ANSWER-external GSW to the head with entry/exit wounds is coded as one or two injuries? - ANSWER- one How many columns are contained within the acetabulum? - ANSWER-two How many hours after injury/arrival should brain injury diagnoses be used for coding? - ANSWER- How many hours POST injury in paralysis should the neurological status of a patient be used to code spinal injuries? - ANSWER- Hypothermia is coded to which ISS body region? - ANSWER-External Hypothermia, electrical injuries, and whole body injuries are coded to which ISS region?
- ANSWER-External If 2nd and 3rd degree burns combined are > 10% TBSA, they should be coded separately or combined? - ANSWER-combined If a head injury is described as penetrating, but there is no skull penetration, what should the injury be coded as? - ANSWER-scalp laceration If a single fracture involves both the skull vault and base, and both are equal in severity, which fracture is coded? - ANSWER-point of origin
Injestion injuries in the chest are coded to which organ? - ANSWER-esophagus Injuries that result from energy dissipated from a penetrating wound are called direct or indirect? - ANSWER-indirect Injuries to bilateral abdominal organs such as the kidneys are coded as combined or separate? - ANSWER-separate Injuries to more than one location of the spinal cord should be coded as combined or separate? - ANSWER-separate Injuries to the shoulders, hip, buttocks, and pelvic girdle are assigned to which ISS body region? - ANSWER-extremities and pelvic girdle Injury descriptors are organized _________________________? - ANSWER- Anatomically Injury severity is ranked relative to its importance to _______________? - ANSWER- The whole body Is "DEATH" part of the severity scale? - ANSWER-NO Is a foreign body considered and injury in and of itself? - ANSWER-NO (cannot code) Is a patient who dies automatically assigned the highest AIS severity of 6? - ANSWER- NO (patients w/ minor injuries can die) Is a perforation always considered a complete transection? - ANSWER-NO Is a positive DPL (diagnostic peritoneal lavage) a codeable injury in and of itself? - ANSWER-NO Is age adjustment required for burns? - ANSWER-YES Is clinical training necessary for collecting injury data? - ANSWER-NO Is death automatically coded as an AIS 6? - ANSWER-NO Is mortality a sole determinant of AIS severity? - ANSWER-NO Is the rib cage considered a single anatomic structure for coding purposes? - ANSWER- YES Is vertebral dislocation coded when a fracture or spinal cord injury is present? - ANSWER-NO
Italics in the AIS dictionary indicate what? - ANSWER-proper-named injuries/structures, OIS grades Level of injury of the spinal cord refers to the most ____________ segment of the cord with normal motor/sensory function. - ANSWER-caudal Level of pelvic instability is determined by extent of damage to which two portions of the pelvis? - ANSWER-1) posterior ligaments
- pelvic floor List five (5) skull bones that comprise the base? - ANSWER-1) ethmoid
- sphenoid
- orbital roof
- portions of occiput
- petrous and mastoid portions of temporal List seven (7) examples of sequela that are coded in AIS as injuries? - ANSWER-1) HTX/PTX
- retroperitoneal hemorrhage
- cerebral edema/swelling
- ischemic brain damage r/t head trauma
- blood loss
- asphyxia
- compartment syndrome List the eight (8) types of hospital/medical record reports from highest to lowest rank in reliability of injury information. - ANSWER-1) Autopsy
- Operative
- Radiology
- Nursing/ICU
- MD progress notes
- ED record
- D/C Summary
- Face Sheet List the five (5) body parts coded in the AIS face body region. - ANSWER-1) eyes
- ears
- nose
- mouth
- facial bones List the four (4) types of injures defined as penetrating? - ANSWER-1) GSW
- Stabbing
- impalement
Once coma is assigned to one AIS descriptor, other head injuries should use which of the AIS descriptions for coma? - ANSWER-NFS Organ injuries may best be described in what type of report? - ANSWER-operative Origins of AIS (3) - ANSWER-1) Standardized system
- Classify type/severity of injury from MVC
- Consensus Parenthesis in the AIS dictionary indicate what? - ANSWER-synonyms or definitions for injury types Partial separation of a joint, or partial dislocation is known as what type of injury? - ANSWER-subluxation Penetrating injuries involving the brain stem are always assigned what AIS? - ANSWER- Penetrating injuries that do not injure underlying structures should be coded in what ISS body region? - ANSWER-External Penetrating injuries that do not involve internal organs or structures should be coded under what ISS body region? - ANSWER-External Penetrating injuries to bones and tissues are coded as what type of fractures to the specific bone? - ANSWER-open PTX/HTX fills what cavity in the chest? - ANSWER-intrapleural space Pubic symphysis separation greater than _________ cm is considered partially unstable. - ANSWER-2. Quadriplegia or paraplegia with no sensation or motor function is classified as what type of cord syndrome? - ANSWER-complete Ripping or tearing away of all layers of skin in which a portion is separated from underlying tissues often creating a flap is known as what type of injury? - ANSWER- avulsion Road rash and friction burns are considered what type of external injury? - ANSWER- abrasion SCIWORA (Spinal Cord Injury without Radiological Abnormality) should be coded as what type of injury? - ANSWER-spinal cord contusion NFS
Semicolons in the AIS dictionary indicate what? - ANSWER-separate injury descriptors that are comparable in severity Severity is NOT contingent upon what two (2) factors? - ANSWER-1) Outcome
- time Should minimally displaced facial fractures be coded as displaced? - ANSWER-NO Should patients with AIS code 9 injuries be included in research studies? - ANSWER- NO Shoulder joint injuries such as acromioclavicular and sternoclavicular are assigned to which ISS body region? - ANSWER-extremities and pelvic girdle SI joint fracture with anterior disruption is considered partially or totally unstable? - ANSWER-partially SI joint fracture with posterior disruption is considered partially or totally unstable? - ANSWER-totally Soft tissue injuries are dispersed across body regions in the AIS book and are coded as what ISS body region? - ANSWER-external Sprains occur to joints or muscles? - ANSWER-joints Sprains refer to the tearing of what type of tissue? - ANSWER-ligament Strains occur to joints or muscles? - ANSWER-muscles Strains refer to the tearing of what type of tissue? - ANSWER-tendon Tearing or ripping apart of tissues from blunt or penetrating force is known as what type of injury? - ANSWER-laceration The brachial plexus is part of what major organ structure? - ANSWER-spine The cheek bone is also known as what? - ANSWER-malar complex The face is divided into how many sections for coding purposes? - ANSWER-three The fifth/sixth digits in the pre-dot code correspond to what? - ANSWER-Level of injury within the specific body region and anatomic structure (NFS, minor, major) The first digit in the pre-dot code corresponds to what? - ANSWER-Body Region
Unilateral rib fxs with same sided unilateral flail chest are coded combined or separate?
- ANSWER-combined Unless specified as base, all skull fractures should be coded as what? - ANSWER-vault Vague descriptions such as "blunt trauma" or "closed head injury" should be assigned which AIS code? - ANSWER- Vertebral dislocations should be coded to which vertebra? - ANSWER-superior Vertical shearing fractures of the pelvis are considered stable, partially unstable, or totally unstable? - ANSWER-totally unstable Vessel thrombosis results in ___________ of the vessel. - ANSWER-Occlusion What AIS code is assigned to a patient with inadequate information regarding an injury?
- ANSWER- What are the six body regions used in the ISS? - ANSWER-1) head & neck
- face
- chest
- abdomen & pelvic organs
- extremities & pelvis
- external What are the two anatomic structures of the pelvis for AIS coding purposes? - ANSWER-1) pelvic ring
- acetabulum What are the two ways an ISS of 75 can be achieved? - ANSWER-1) AIS of 5 in each of three different body regions
- AIS of 6 in a single body region What bone is associated with the malar complex (cheek)? - ANSWER-zygoma What facial bone must be fractured to have a LeFort fracture? - ANSWER-pterygoid plate What five (5) physical signs/manifestations are codeable as basilar skull fx? - ANSWER-1) raccoon's eyes (periorbital ecchymosis)
- Battle's sign (mastoid ecchymosis)
- CSF rhinorrhea
- CSF otorrhea
- hemotympanum
What four (4) things define the "average" patient? - ANSWER-1) 25-40 yrs old
- no pre-existing conditions
- no tx complications
- received timely/appropriate care What is considered the least reliable source of injury information? - ANSWER-patient What is important to look for when coding blunt trauma? - ANSWER-associated/underlying injuries What is the only nerve included in the Face AIS body region? - ANSWER-optic (intraorbital) What is the only vessel included in the Face AIS body region? - ANSWER-external carotid (and its branches, facial/internal maxillary) What membrane lines the chest wall? - ANSWER-Parietal pleura What membrane lines the organ? - ANSWER-visceral What must also exists to code a basilar skull fx when only physical manifestations are present? - ANSWER-evidence of head trauma (not r/t facial fx/injury) What part of the AIS code is considered the "AIS Severity Number?" - ANSWER-single digit after the decimal (right) What part of the AIS code is considered the "Pre-Dot Code?" - ANSWER-6 digits BEFORE the decimal point (left) What should be used when a specific artery or vein is not named in the AIS description but is injured? - ANSWER-other named What two injuries must occur for a skull fracture to be termed "open?" - ANSWER-1) torn dura
- compound fracture What two ISS body regions may the aorta and vena cava be coded under depending on the location of their injury? - ANSWER-chest abdomen What two things must be present to code LOC? - ANSWER-1) evidence of head trauma
- dx by a physician What type of organ injury involves the ripping away of an organ from its vascular attachment? - ANSWER-avulsion
When only one ductal injury is occurs, it should be assigned to EITHER, or BOTH of the associated organs? - ANSWER-either When should the AIS body region external codes be used for skin injuries? - ANSWER- no body region info is available When there is any question about the severity of an injury based upon all available information the coder should chose the __________ severe AIS code in that category. - ANSWER-least When two ends of a bone are not aligned the fracture is called what? - ANSWER- displaced When two parts of a structure are completely separated from each other it is known as what type of injury? - ANSWER-transection Which are typically more extensive - degloving or avulsion? - ANSWER-degloving Which portion of the aorta is coded to the chest ISS region? - ANSWER-thoracic Which two sections of the ISS body region for head can DAI be coded under? - ANSWER-1) cerebrum
- concussion Which two types of vertebral fractures are coded in addition to multiple fractures of same vertebra? - ANSWER-1) odontoid
- major compression Which type of measurement is more variable? Anatomic or Physiologic? - ANSWER- Physiologic Which type of report is highest on the ranking of most reliable sources of injury information? - ANSWER-M.E./Autopsy reports Whole body blast injuries are assigned an AIS code of _______ and are coded to which ISS body region? - ANSWER-6;External With penetrating injuries to internal structures, is the overlying skin injury coded separately? - ANSWER-NO
