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CBIS Exam 202 6 Questions and Answers CBIS Exam 202 6 Questions with correct Answers, Exams of Community Corrections Acute Brain Injury - ANSWERAn injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma Traumatic Brain Injury - ANSWERAn alteration in brain function, or other evidence of brain pathology, caused by an external force 2 Mechanisms *trauma impact
- traumatic inertial forces Non-traumatic brain injury - ANSWERLack of O2, decreased nutrients to cells, exposure to toxins, pressure from tumor or blockage or other neuro disorder ABI Prevalence - ANSWER2nd most prevalent disability in U. S.
- 13.5 million Americans Children & TBI - ANSWER* non-accidental trauma cause of 80% of deaths in children under 2yo
- 2/3 of children under 3yo that are abused have TBIs *falls cause 1/2 of TBI in 0-14yo
domestic violence - ANSWER67% of women in domestic violence had TBI symptoms Mild TBI - ANSWER*concussion *LOC > 30 min *loss of memory >24hrs *CGS 13- 15 *normal CT or MRI any AMS at time of incident Moderate TBI - ANSWERLOC up to 24hrs *neuro signs of brain trauma
- CGS 9- 12 may have focal findings on CT Severe TBI - ANSWERLOC <24hrs *GCS 3- 8 Screens for TBI - ANSWERACE - acute concussion eval HELPS WARCAT - warrior administered retrospective casualty assessment tool TBIQ - traumatic brain injury questionnaire ImPACT OSU TBI ID
Persistent post concussive symptoms - ANSWERA complex disorder following a concussion, lasting for weeks or months, consisting of symptoms such as headaches or dizziness, Nausea, post Trumatic amnesia and GCS of 13/ Must be diagnosed by neuropsychologist Somatization - ANSWERThe expression of psychological distress through physical symptoms Chronic traumatic encephalopathy - CTE - ANSWERRare, progressive, degenerative condition of central nervous system that is seen and repetitive brain trauma Dementia, memory loss, aggression, confusion, depression Hebbian Learning - ANSWERNeurons that fire together, wire together Experience independent learning - ANSWER" use it or lose it" Synaptogenesis - ANSWERThe process by which neurons form new connections Disorders of consciousness - ANSWERComa, Vegetative State, minimally conscious state Coma - ANSWER* no evidence of arousal
- no response to internal or extrnal stimuli
- May have reflexive response
- resolves in 2 to 4 weeks
Vegetative state - ANSWERTransition of severely brain damaged patients from a coma to wakefulness without awareness Can be months to years in this state Minimally conscious state - ANSWERcondition in which someone has brief periods of purposeful actions and speech comprehension Emergence from DOC - ANSWERRequires at least one criteria:
- functional communication by verbal or gestural Y/N response
- functional use of 2 or more objects Automatic dysfunction syndrome - ANSWEREpisodes of: dystonia (abnormal muscle tone), tachycardia, diaphoresis (sweating), hyperthermia, hypertension, tachypnea (rapid breathing) *occurs in 15%-33% of severe TBI Sleep Complications - ANSWERHypogenic hallucinations - vivid dream like auditory, visual, or tactile sensations on experiences between sleep and wake Cataplexy - feature of narcolepsy. Sudden loss of muscle tone. Consciousness remains clear, memory not impaired and respirations intact Immediate post Trumatic convulsions (seizures) - ANSWERLOC & involuntary movements within seconds of impact can be asymmetrical, short period of AMS & retrograde amnesia Early post Trumatic seizures - ANSWERoccurs within the first week
neuralgia - ANSWERnerve pain Neuromas - ANSWERNerve endings adhered to scar tissue Hydrocephalus ex vacuo - ANSWERAppearance of increased CSF in atrophy. Intracranial pressure normal, brain smaller Spasticity - ANSWERDamage to upper motor neuron Faster and extremity is moved = stronger the spasm heterotopic ossification - ANSWERcaused by bone formation in soft tissues Dysautonomia - ANSWERImbalance between sympathetic and parasympathetic NS " autonomic storming"
- present with muscle over reactivity, posturing, dystonia, rigidity and spasticity Common Infections - ANSWERMeningitis, respiratory infections, UTI, surgical site infections, cellulitis, urosepsis Stages of motor learning - ANSWER*cognitive (what to do) *Associative (how to do) *Autonomis (how to succeed)
Cranial nerve dysfunction - ANSWERVisual disturbance, facial dropping, postural instability, dysphagia, autonomic dysregulation Athetiod - ANSWERSlow, involuntary, writhing movements Ballisms - ANSWERQuick flailing movements choreiform movements - ANSWERContinuous rapid & unpredictable movements Agnosia - ANSWERLoss of ability to identify people or objects. Visual, auditory or tactile Apraxia - ANSWERInability to perform purposeful movement *ideomotor- unable to perform tasks on command *ideational- unable to perform automatic tasks *buccofacial- limitations and performing purposeful movement of lips, cheeks, tongue, larynx and pharynx central cord syndrome - ANSWERPresents as weakness & numbness in arms
- results from fall in with neck in hyperextention or with arthritis or spondylosis
- bowel/bladder issues
- able to walk however unable to grasp things Brown-Sequard Syndrome - ANSWER1 side of spinal cord injured
Long term memory - ANSWERExplicit vs implicit Executive Functions - ANSWER* complex cognitive processes that involve reasoning, planning, judgment, initiation and abstract thinking Cognitive rehab approaches - ANSWER*approach in systemic manner *analyzing problems *consider alternative solutions *prioritizing solutions *review outcomes Metacognition (n) - ANSWERAwareness of thoughts 3 levels of metacognition - ANSWER1) awareness of deficits
- awareness of functional implications
- awareness to set realistic goals Anosognosia - ANSWERDiminished self awareness and failure to recognize a personal disability Cognitive Rehab - Compensatory Approach - ANSWER*assumes some cognitive functions can't be recovered *focus on development of strategies *functional application is important
Cognitive Rehab - Restorative Approach - ANSWER*repeated exposure & repetition through experience therapeutic exercise to re-establish/strengthen specific cog skills Principles of Cognitive Rehab - ANSWERtx of impairments must be hierarchical *basic cognition skills first *target attention, perception, categorization, abstract thinking, & memory Stability Triangle - ANSWER Extinction - ANSWERWhen a previously reinforced response no longer produces a consequence, leading to an eventual decline in rate continuous reinforcement - ANSWERthe reinforcement of each and every correct response intermittent reinforcement - ANSWERreinforcement for some responses and not for others Topography - ANSWERWhat a behavior looks like physically Behavior TX Approach - ANSWER1) assess behavior
- define target behavior
- collect data
- change behavior
bipolar II disorder - ANSWEROne or more depressive episode followed by one or more hypomanic episode cyclothymic disorder - ANSWERChronic fluctuation mood disturbance including both depressive and hypo manic states Schizophrenia - ANSWERDisorder lasting for at least 6mo with minimum of a 1 month phase of symptoms that include: delusions, hallucinations, incoherent speech, Catalonia or avolition. personality disorders - ANSWER23% of TBI pts Organic personality disorder Frontal Lobe Syndrome - ANSWERSymptoms of other psychiatric disorders including depression, psychosis, mood disorders and other various conditions however the patient does not recognize these conditions
- The difference between frontal lobe injury and regular depression is the patient's ability to recognize and acknowledge the deficit SUD interventions - ANSWER Screens for SUD - ANSWER*AUDIT - alcohol use disorder identification test *CAGE: yes or no questions *CRAFFT: screen for adolescents *ASSIST: alcohol, smoking and substance use involvement screening test Cranial Nerves - ANSWER
concomitant spinal cord injury - ANSWERPresent of co-occurring spinal cord injury and brain injury 60% of SCI pt's Visual Functions - ANSWER Somatoagnosia - ANSWERLack of awareness of body structure and body part relationships Meninges - ANSWER Vestibular conditions - ANSWERlabrynththine concussion *post-traumatic Ménière's disease *basilar skull fx *vestibular migraine *perilymphatic fistula *benign paroxysmal positional vertigo (BPPV) *B vestibular hypofunction *central vertigo Olmstead Decision - ANSWERA ruling made by the US Supreme Court requiring the provision of community based services with such services are available and not opposed by the patient in question, As opposed to being institutionalized.
mTBI Adolescents - ANSWERStudent athletes with concussion must be evaluated, treated, and followed - up by health care professionals Second Impact Syndrome - ANSWERCan occur when an athlete sustains an initial concussion and then sustains a second head injury before the symptoms from the first have fully resolved Tenet I - ANSWERCurrent physical brain is related to the past physical state of our brain Tenet II - ANSWEROur psychological state is the result of a 3 part constant reciprocally interacting relationship Moral Model of Disability - ANSWEROldest model Disability is result of sin, evil or character flaw Biomedical Model of Disability - ANSWERUses objective, clear-cut, standardized measures and expert to provide finding characteristics, causes, prognosis and treatment 2 demential (normal vs. illness) Environmental Model of Disability - ANSWEREnvironment, social and physical can cause, defined or exaggerate a disability Prejudice, discrimination stigma lies with the environment and not the disability
Functional Model of Disability - ANSWERMost individualized and personal model (patient centered care) Extend in consequences for disability in consideration of person specific interest and participation Emphasizes DMEs sociopolitical model of Disability - ANSWERMinority group for independent living model Disability is collective concern of society Societies responsibility for accommodating patient rather than the patient accommodating to society Six principles of person centered care - ANSWERAutonomy, beneficence, non- maleficence, fidelity, justice, veracity Beneficence (Definition) - ANSWERThe clinicians obligation to do good for the patient Fidelity - ANSWERClinician should keep promises made Veracity - ANSWERThe clinician to be truthful and professional interactions Section 504 of Rehabilitation Act - ANSWEREqual treatment, and appropriate education for people with disabilities Preferential seating, extended time on exams, test in quiet, rest breaks, shortened assignments, books on CD
Military acute concussion evaluation (MACE) - ANSWERTBI screening developed by defense and veterans BI center. Provides gross measures of cognitive domain TBI military prevalence - ANSWERmTBI only 56% mTBI & PTSD 44% Community integrated rehabilitation (CIR) - ANSWERPost acute brain injury rehabilitation programs designed to support persons with brain injury in the community. Can include neural behavioral programs, residential programs, day treatment programs and home based programs Neural behavioral programs - ANSWERFor Severe behavioral disturbances that require 24 hour supervision. Residential community program - ANSWERFor those that cannot participate as outpatient, require 24 hour supervision or support Comprehensive holistic treatment/day treatments - ANSWERThere is a need for intensive services and can benefit from improved awareness Home based program - ANSWERClient is able to resign at the home and able to self direct care Care management - ANSWERContinuous system of care for a particular condition
Case management, life care planning, advocacy and public policy, support groups case management - ANSWERA way of managing unique and high risk conditions often associated with costly acute care and hospital stay. Case Manager Functions - ANSWEREducator, coordinator, research, communicator, collaborator, clinician, utilization manager, transition planner, leader, quality manager, negotiator, advocate, risk manager 6 Domains if Case Management - ANSWERProcesses and services, resource utilization in management, psychosocial and economic support, rehabilitation, outcomes and ethical and legal practices Life care planning - ANSWERA lifelong needs assessment of the needed goods and services required for a person with brain injury to move the most independent life possible. The plan should've called blueprints for families Must utilize evidence based standard of care LCP plan - ANSWERShould be continually monitored and revised when the persons health needs or situation changes. Special needs trust - ANSWERA legal arrangement in financial agreement that allows a person with a brain injury to receive income without reducing their eligibility for the public assistance disability benefits provided by Social Security, supplemental security income, Medicare or Medicaid Types of special needs trusts - ANSWERFirst party SNT, third-party SNT, Inter vivos (during life) SNT, pooled trust/community trust
