Sensing Medicine • 100 TBI MCQ

100 MCQ on Traumatic Brain injury for various post graduate and fellowships entrance examination

Choose a set below. Total 100 multiple choice questions on Traumatic Brain Injury. Each set contains 25 single-best-answer questions and opens in a distraction-free full-screen examination interface. Across all four sets, the bank contains 25% easy, 50% moderate and 25% hard questions. Questions can be attempted, reviewed, cleared and revisited before final submission.

4 Sets MCQ on Traumatic Brain Injury
25 Questions / Set 100 questions in total
25 Minutes / Set NEET-PG-style practice interface
+4 / −1 NEET PG-style marking
1

Traumatic Brain Injury Set 1

25 questions • 25 minutes • +4 / −1

2

Traumatic Brain Injury Set 2

25 questions • 25 minutes • +4 / −1

3

Traumatic Brain Injury Set 3

25 questions • 25 minutes • +4 / −1

4

Traumatic Brain Injury Set 4

25 questions • 25 minutes • +4 / −1

Original educational question bank with 100 MCQ on Traumatic Brain Injury. Overall difficulty distribution: 25 easy, 50 moderate and 25 hard questions. Practice for NEET PG, INI-CET, FMGE, MD PMR and medical fellowship entrance examinations.

100 MCQ on Traumatic Brain Injury with Answers and Explanations

Prefer to revise before attempting a timed examination? Browse all four sets here. Every question, its four answer choices, and an expandable explanation. For an examination without visible answers, use the Start Set buttons above.

Set 1: Questions 1–25

Question 1. A patient opens eyes to speech, uses inappropriate words, and localizes painful stimulus. What is the GCS score?

  1. 10
  2. 11
  3. 12
  4. 13
Reveal correct answer and explanation

Correct answer: B. 11

Eye opening to speech E3, inappropriate words V3 and localization M5 give a total GCS of 11.

Question 2. A patient opens eyes to speech, is confused but converses, and obeys commands. What is the GCS?

  1. 11
  2. 12
  3. 13
  4. 14
Reveal correct answer and explanation

Correct answer: C. 13

Eye 3 + verbal 4 + motor 6 equals 13.

Question 3. Which GCS motor response corresponds to withdrawing from a painful stimulus?

  1. M2
  2. M3
  3. M4
  4. M5
Reveal correct answer and explanation

Correct answer: C. M4

M4 is normal flexion or withdrawal; M5 is localization.

Question 4. The usual post-resuscitation GCS category for severe TBI is:

  1. 3–8
  2. 9–12
  3. 13–15
  4. 10–15
Reveal correct answer and explanation

Correct answer: A. 3–8

Severe TBI is generally GCS 3–8, moderate 9–12 and mild 13–15; document effects of drugs and sedation.

Question 5. A patient is intubated after TBI. Which GCS recording is most informative?

  1. GCS 3 by default
  2. Only a single total score
  3. Component scores, with verbal marked not testable
  4. Assign verbal score of five
Reveal correct answer and explanation

Correct answer: C. Component scores, with verbal marked not testable

An intubated verbal response cannot be tested; document E, M, and V-NT rather than invent a normal or minimum verbal score.

Question 6. Which factor is a potentially preventable secondary brain insult?

  1. Diffuse axonal shearing at impact
  2. Cerebral contusion at impact
  3. Systemic hypoxemia after injury
  4. Primary axonal transection
Reveal correct answer and explanation

Correct answer: C. Systemic hypoxemia after injury

Hypoxemia and hypotension aggravate secondary ischemic brain injury.

Question 7. Rotational acceleration of the head most strongly predisposes to:

  1. Diffuse axonal injury
  2. Isolated scalp laceration
  3. Hydrocephalus ex vacuo
  4. Pituitary adenoma
Reveal correct answer and explanation

Correct answer: A. Diffuse axonal injury

Rotational forces stretch axons in white matter and callosal/brainstem pathways.

Question 8. The classical distribution of DAI includes the:

  1. Thalamus only
  2. Gray–white junction, corpus callosum and brainstem
  3. Occipital bone only
  4. Ventricular choroid plexus only
Reveal correct answer and explanation

Correct answer: B. Gray–white junction, corpus callosum and brainstem

Common DAI sites include the gray–white junction, corpus callosum and dorsolateral brainstem.

Question 9. A deeply unconscious patient after a high-speed collision has an initially near-normal CT. Which injury should be suspected?

  1. Chronic subdural hematoma
  2. Diffuse axonal injury
  3. Benign positional vertigo
  4. Extradural hematoma with mass effect
Reveal correct answer and explanation

Correct answer: B. Diffuse axonal injury

Severe impairment with relatively little CT abnormality suggests DAI; MRI is more sensitive.

Question 10. Which MRI sequence is particularly sensitive for traumatic microhemorrhages in DAI?

  1. T1 without contrast
  2. Susceptibility-weighted imaging
  3. MR angiography alone
  4. Diffusion tensor tractography alone
Reveal correct answer and explanation

Correct answer: B. Susceptibility-weighted imaging

SWI detects susceptibility from small hemorrhagic lesions; MRI can also assess nonhemorrhagic injury.

Question 11. A brief lucid interval followed by deterioration after temporal trauma classically suggests:

  1. Epidural hematoma
  2. Diffuse axonal injury
  3. Concussion only
  4. Post-traumatic hydrocephalus
Reveal correct answer and explanation

Correct answer: A. Epidural hematoma

Epidural hematoma may follow a lucid interval, although it is not universal.

Question 12. A lens-shaped hyperdense extra-axial collection on noncontrast head CT is typical of:

  1. Subdural hematoma
  2. Epidural hematoma
  3. Subarachnoid hemorrhage
  4. Intraventricular hemorrhage
Reveal correct answer and explanation

Correct answer: B. Epidural hematoma

Epidural blood is classically biconvex because sutures constrain its spread.

Question 13. Which vessel is classically injured with temporal extradural hemorrhage?

  1. Middle meningeal artery
  2. Anterior cerebral artery
  3. Internal jugular vein
  4. Superior sagittal sinus in every case
Reveal correct answer and explanation

Correct answer: A. Middle meningeal artery

A temporal bone fracture can tear the middle meningeal artery; some epidural hematomas are venous.

Question 14. A crescent-shaped extra-axial collection that crosses sutures most suggests:

  1. Epidural hematoma
  2. Subdural hematoma
  3. Intraparenchymal hemorrhage
  4. Intraventricular hemorrhage
Reveal correct answer and explanation

Correct answer: B. Subdural hematoma

Subdural collections commonly extend across sutures but are constrained by dural reflections.

Question 15. A typical mechanism of traumatic acute subdural hematoma is injury to:

  1. Bridging veins
  2. Ophthalmic artery
  3. Facial artery
  4. Vertebral venous plexus only
Reveal correct answer and explanation

Correct answer: A. Bridging veins

Bridging veins are often implicated; acute subdural hematomas can also result from cortical vessel injuries.

Question 16. Which population has increased susceptibility to chronic subdural hematoma after minor trauma?

  1. Young adults with normal coagulation exclusively
  2. Older people with brain atrophy or anticoagulant use
  3. Only infants with no trauma
  4. Only marathon runners
Reveal correct answer and explanation

Correct answer: B. Older people with brain atrophy or anticoagulant use

Cerebral atrophy and antithrombotic therapy increase risk; chronic subdural blood may evolve over weeks.

Question 17. Which description best identifies traumatic subarachnoid hemorrhage on CT?

  1. Blood tracking within sulci and cisterns
  2. A strictly biconvex epidural collection
  3. Only an intraventricular fluid level
  4. A hypodense scalp collection
Reveal correct answer and explanation

Correct answer: A. Blood tracking within sulci and cisterns

Traumatic SAH appears as hyperdensity within subarachnoid sulci and cisterns.

Question 18. Coup–contrecoup injury describes:

  1. Bilateral carotid dissection
  2. Injury at impact and on the opposite side
  3. Spinal cord injury without head injury
  4. Identical lesions restricted to the skull
Reveal correct answer and explanation

Correct answer: B. Injury at impact and on the opposite side

Contact and inertial forces can cause contusions at and opposite the point of impact.

Question 19. Which brain regions are frequently involved by traumatic contusions?

  1. Orbitofrontal and temporal poles
  2. Primary visual cortex exclusively
  3. Cerebellar tonsils exclusively
  4. Caudate nuclei exclusively
Reveal correct answer and explanation

Correct answer: A. Orbitofrontal and temporal poles

Inferior frontal and anterior temporal surfaces contact bony ridges during acceleration.

Question 20. A patient after blunt head trauma develops unilateral fixed dilated pupil and declining consciousness. The emergency concern is:

  1. Uncal herniation
  2. Normal sleep physiology
  3. Isolated peripheral vertigo
  4. Conversion disorder
Reveal correct answer and explanation

Correct answer: A. Uncal herniation

Compression of the ipsilateral third nerve with mass effect suggests transtentorial/uncal herniation.

Question 21. Cushing response consists of:

  1. Hypotension, tachycardia and fever
  2. Hypertension, bradycardia and irregular respirations
  3. Hypertension, tachycardia and polyuria
  4. Hypotension, bradypnea and miosis
Reveal correct answer and explanation

Correct answer: B. Hypertension, bradycardia and irregular respirations

The triad is a late ominous sign of raised ICP and brainstem compromise.

Question 22. In adults, a common Brain Trauma Foundation threshold for treating intracranial hypertension is sustained ICP:

  1. Above 5 mm Hg
  2. Above 12 mm Hg
  3. Above 22 mm Hg
  4. Above 50 mm Hg only
Reveal correct answer and explanation

Correct answer: C. Above 22 mm Hg

BTF severe TBI guidance recommends treating ICP above 22 mm Hg; decisions consider the complete clinical picture.

Question 23. If MAP is 85 mm Hg and ICP is 20 mm Hg, CPP equals:

  1. 45 mm Hg
  2. 65 mm Hg
  3. 85 mm Hg
  4. 105 mm Hg
Reveal correct answer and explanation

Correct answer: B. 65 mm Hg

CPP = mean arterial pressure − intracranial pressure = 85 − 20 = 65 mm Hg.

Question 24. The usual adult severe TBI CPP target range in BTF guidelines is:

  1. 20–30 mm Hg
  2. 40–50 mm Hg
  3. 60–70 mm Hg
  4. 90–110 mm Hg
Reveal correct answer and explanation

Correct answer: C. 60–70 mm Hg

A CPP target of 60–70 mm Hg is recommended, individualized to cerebral autoregulation.

Question 25. According to the Monro–Kellie concept, rising intracranial volume becomes hazardous because:

  1. The adult cranial vault has limited capacity to expand
  2. Cerebral CSF production ceases permanently
  3. Blood cannot circulate through brain tissue
  4. Skull sutures always separate in adults
Reveal correct answer and explanation

Correct answer: A. The adult cranial vault has limited capacity to expand

Brain, CSF and blood compete for space in the rigid adult skull; exhausted compensation increases ICP rapidly.

Set 2: Questions 26–50

Question 26. For an unconscious trauma patient with suspected cervical injury, the first priority is:

  1. Check deep tendon reflexes
  2. Secure oxygenation and airway while protecting the cervical spine
  3. Perform formal memory testing
  4. Initiate walking training
Reveal correct answer and explanation

Correct answer: B. Secure oxygenation and airway while protecting the cervical spine

Airway and oxygenation with cervical spine precautions precede definitive neurologic testing.

Question 27. A motorcyclist has GCS 7 and inadequate airway protection. Most appropriate action?

  1. Send home for observation
  2. Secure the airway with cervical spine precautions
  3. Administer oral sedative
  4. Start cognitive rehabilitation immediately
Reveal correct answer and explanation

Correct answer: B. Secure the airway with cervical spine precautions

Severe impaired consciousness and airway compromise warrant airway control by a trained team.

Question 28. A linear fracture across the temporal squama makes which intracranial lesion particularly important to exclude?

  1. Epidural hematoma
  2. Pituitary microadenoma
  3. Normal-pressure hydrocephalus
  4. Multiple sclerosis
Reveal correct answer and explanation

Correct answer: A. Epidural hematoma

Temporal fractures may damage the middle meningeal vascular system.

Question 29. Bilateral periorbital ecchymoses after head trauma raises suspicion for:

  1. Basilar skull fracture
  2. Isolated lumbar strain
  3. Subarachnoid cyst
  4. Trigeminal neuralgia
Reveal correct answer and explanation

Correct answer: A. Basilar skull fracture

Raccoon eyes may indicate anterior skull-base fracture; timing can be delayed.

Question 30. Postauricular bruising (Battle sign) after blunt head injury suggests:

  1. Basilar skull fracture
  2. Brachial plexus palsy
  3. Myasthenia gravis
  4. Temporal arteritis
Reveal correct answer and explanation

Correct answer: A. Basilar skull fracture

Battle sign can accompany temporal or skull-base fractures.

Question 31. Which procedure should be avoided in a patient with suspected anterior skull-base fracture until safety is established?

  1. Pulse oximetry
  2. Blind nasal instrumentation
  3. Peripheral intravenous access
  4. Noncontrast CT head
Reveal correct answer and explanation

Correct answer: B. Blind nasal instrumentation

Blind nasogastric or nasotracheal passage can be hazardous in selected skull-base injuries; use a safer approach.

Question 32. Which statement about prophylactic corticosteroids in severe TBI is correct?

  1. High-dose methylprednisolone improves survival
  2. Steroids are contraindicated for routine severe TBI treatment because high-dose therapy increased mortality
  3. Steroids routinely lower ICP and should be given
  4. They replace urgent surgical evacuation
Reveal correct answer and explanation

Correct answer: B. Steroids are contraindicated for routine severe TBI treatment because high-dose therapy increased mortality

BTF recommends against corticosteroids for outcome improvement or ICP reduction; high-dose methylprednisolone is contraindicated.

Question 33. A patient has large acute epidural hematoma with volume 40 cm³. Under BTF surgical guidance, the management is:

  1. Routine discharge
  2. Surgical evacuation regardless of GCS
  3. Elective outpatient MRI
  4. Treat with aspirin
Reveal correct answer and explanation

Correct answer: B. Surgical evacuation regardless of GCS

Epidural hematoma greater than 30 cm³ merits surgical evacuation irrespective of GCS under BTF surgical guidance.

Question 34. A patient has an acute SDH with 7 mm midline shift but only 6 mm hematoma thickness. Which is true?

  1. No neurosurgical concern because thickness is under 10 mm
  2. Midline shift independently satisfies a guideline surgical criterion
  3. Repeat CT only after one month
  4. It is an epidural collection
Reveal correct answer and explanation

Correct answer: B. Midline shift independently satisfies a guideline surgical criterion

Shift greater than 5 mm independently supports operative evacuation for acute SDH.

Question 35. Which statement best describes hypertonic saline and mannitol for elevated ICP?

  1. Neither can change ICP
  2. Both are hyperosmolar options, with choice depending on physiology and local protocol
  3. Both are routinely used in every mild TBI
  4. Both replace neurosurgical consultation
Reveal correct answer and explanation

Correct answer: B. Both are hyperosmolar options, with choice depending on physiology and local protocol

Hyperosmolar therapy can reduce ICP; the agents differ in hemodynamic and electrolyte effects.

Question 36. What is the major danger of sustained prophylactic hyperventilation in early severe TBI?

  1. It always raises PaCO2
  2. Cerebral vasoconstriction may reduce cerebral blood flow
  3. It removes need for oxygenation
  4. It eliminates brain edema permanently
Reveal correct answer and explanation

Correct answer: B. Cerebral vasoconstriction may reduce cerebral blood flow

Lower PaCO2 reduces cerebral blood volume but can worsen ischemia; prolonged prophylactic hyperventilation is not recommended.

Question 37. What is the appropriate interpretation of post-traumatic anisocoria with falling GCS?

  1. It is reassuring
  2. It requires urgent reassessment for expanding mass lesion or herniation
  3. It proves spinal shock
  4. It is diagnostic of psychogenic symptoms
Reveal correct answer and explanation

Correct answer: B. It requires urgent reassessment for expanding mass lesion or herniation

New pupillary asymmetry and deterioration are neurocritical emergencies.

Question 38. Which circumstance justifies repeat urgent cranial imaging after a previously stable scan?

  1. New neurologic deterioration
  2. Stable normal examination without new concern only
  3. Improvement in headache
  4. Completed discharge paperwork
Reveal correct answer and explanation

Correct answer: A. New neurologic deterioration

New deficits or declining consciousness warrant prompt evaluation for lesion progression.

Question 39. A patient with TBI develops a generalized seizure 48 hours after injury. It is classified as:

  1. Late post-traumatic seizure
  2. Early post-traumatic seizure
  3. Absence seizure exclusively
  4. Psychogenic event by definition
Reveal correct answer and explanation

Correct answer: B. Early post-traumatic seizure

Early seizures occur within the first seven days after TBI.

Question 40. Which presentation most suggests a depressed skull fracture needing urgent specialist assessment?

  1. Palpable skull depression after focal impact
  2. Minor isolated scalp bruise only
  3. Transient nausea with normal examination
  4. Old healed abrasion
Reveal correct answer and explanation

Correct answer: A. Palpable skull depression after focal impact

Depressed or open fractures may need surgery, wound management and infection prophylaxis depending on features.

Question 41. An intracranial air collection after head trauma is termed:

  1. Pneumocephalus
  2. Hydrocephalus
  3. Leukoaraiosis
  4. Pachymeningitis
Reveal correct answer and explanation

Correct answer: A. Pneumocephalus

Pneumocephalus implies communication with air-containing spaces or penetrating trauma; tension pneumocephalus is emergent.

Question 42. Which is the best initial disposition for GCS 6 with abnormal CT after trauma?

  1. Home with family
  2. A center with critical care and neurosurgical capability
  3. Routine physiotherapy clinic
  4. Psychiatric outpatient service
Reveal correct answer and explanation

Correct answer: B. A center with critical care and neurosurgical capability

Severe TBI with an abnormal scan requires close neurocritical and neurosurgical management.

Question 43. What is the main reason to document a pre-intubation neurologic examination?

  1. Sedatives and paralysis can obscure subsequent examination
  2. To avoid recording GCS later
  3. To substitute for CT
  4. To exclude spinal injury automatically
Reveal correct answer and explanation

Correct answer: A. Sedatives and paralysis can obscure subsequent examination

Pre-sedation pupils, motor findings and GCS provide a crucial baseline.

Question 44. The primary mechanism of diffuse cerebral swelling following TBI may include:

  1. Loss of autoregulation and tissue edema
  2. Increased skull bone thickness
  3. Only external scalp edema
  4. Isolated retinal hemorrhage
Reveal correct answer and explanation

Correct answer: A. Loss of autoregulation and tissue edema

Disordered cerebral perfusion, vascular congestion and cellular edema contribute to intracranial hypertension.

Question 45. Following severe TBI, a patient consistently keeps eyes open but demonstrates no reproducible evidence of awareness. Which diagnosis is most compatible?

  1. Minimally conscious state
  2. Unresponsive wakefulness syndrome
  3. Locked-in syndrome
  4. Normal sleep
Reveal correct answer and explanation

Correct answer: B. Unresponsive wakefulness syndrome

UWS entails wakefulness without behavioral evidence of awareness on sufficiently repeated, confounder-aware assessment.

Question 46. Which finding most strongly supports minimally conscious state rather than UWS?

  1. Reflexive eye opening alone
  2. Reproducible visual pursuit
  3. Extensor posturing
  4. Spontaneous breathing
Reveal correct answer and explanation

Correct answer: B. Reproducible visual pursuit

Visual pursuit or other reproducible nonreflexive behaviors indicate minimal but definite awareness.

Question 47. Which standardized tool is recommended for repeated detailed behavioral assessment in disorders of consciousness?

  1. Coma Recovery Scale–Revised
  2. Oswestry Disability Index
  3. Apgar score
  4. Wells DVT score
Reveal correct answer and explanation

Correct answer: A. Coma Recovery Scale–Revised

CRS-R evaluates auditory, visual, motor, oromotor, communication and arousal behaviors.

Question 48. Why must disorders-of-consciousness assessment be repeated on different occasions?

  1. Responses fluctuate and confounders may mask awareness
  2. A single assessment is always definitive
  3. Serial examinations cannot change diagnosis
  4. Pain medications never affect behavior
Reveal correct answer and explanation

Correct answer: A. Responses fluctuate and confounders may mask awareness

Arousal, fatigue, sensory impairments and drugs can cause fluctuating responsiveness.

Question 49. The FOUR score differs from GCS by incorporating:

  1. Brainstem reflexes and respiratory pattern
  2. Serum electrolytes
  3. Anterograde memory only
  4. Walking speed
Reveal correct answer and explanation

Correct answer: A. Brainstem reflexes and respiratory pattern

FOUR includes eye, motor, brainstem and respiratory domains; it avoids a verbal subscore.

Question 50. Which instrument is used in some settings to monitor resolution of post-traumatic amnesia?

  1. Westmead Post-Traumatic Amnesia Scale
  2. Modified Ashworth Scale
  3. NIH Stroke Scale exclusively
  4. Berg Balance Scale
Reveal correct answer and explanation

Correct answer: A. Westmead Post-Traumatic Amnesia Scale

The Westmead scale follows orientation and new learning during recovery from PTA.

Set 3: Questions 51–75

Question 51. The Rancho Los Amigos Levels are primarily used to describe:

  1. Cognitive-behavioral recovery following brain injury
  2. Fracture union
  3. Peripheral nerve conduction velocity
  4. Renal clearance
Reveal correct answer and explanation

Correct answer: A. Cognitive-behavioral recovery following brain injury

Rancho levels characterize evolving cognitive functioning and assistance needs after brain injury.

Question 52. A TBI survivor is confused, restless, distractible and nonpurposeful. Which Rancho level is classically associated with this presentation?

  1. Level II
  2. Level IV
  3. Level VII
  4. Level X
Reveal correct answer and explanation

Correct answer: B. Level IV

Level IV is confused-agitated, usually requiring structured, low-stimulation care.

Question 53. Which clinical factor should delay out-of-bed mobilization following severe TBI?

  1. Uncontrolled intracranial hypertension or cardiorespiratory instability
  2. A stable oxygen requirement alone
  3. Presence of a physiotherapist
  4. Family requesting education
Reveal correct answer and explanation

Correct answer: A. Uncontrolled intracranial hypertension or cardiorespiratory instability

Rehabilitation starts early but mobility is advanced only when cerebral and systemic physiology permits.

Question 54. An immobilized TBI patient with evolving ankle plantarflexion contracture benefits most from:

  1. Positioning, range-of-motion care and appropriate splinting
  2. Prolonged unmodified bed rest
  3. No limb handling for months
  4. Unsupervised maximal-force stretch
Reveal correct answer and explanation

Correct answer: A. Positioning, range-of-motion care and appropriate splinting

Contracture prevention includes frequent positioning, skin checks, safe range of motion and individualized orthoses.

Question 55. A patient after TBI develops episodic tachycardia, hypertension, sweating and dystonic posturing after stimulation. Most likely:

  1. Paroxysmal sympathetic hyperactivity
  2. Simple orthostatic hypotension
  3. Isolated bacterial meningitis
  4. Benign essential tremor
Reveal correct answer and explanation

Correct answer: A. Paroxysmal sympathetic hyperactivity

PSH is episodic sympathetic and motor overactivity after severe acquired brain injury; exclude seizures, pain and infection.

Question 56. The best interpretation of post-TBI hypertonia is that:

  1. Every increased resistance is spasticity
  2. Spasticity and fixed soft-tissue contracture must be distinguished
  3. Stretch always abolishes all tone
  4. Tone does not affect care
Reveal correct answer and explanation

Correct answer: B. Spasticity and fixed soft-tissue contracture must be distinguished

Velocity dependence, end range and passive tissue properties help separate reflex hyperexcitability from contracture.

Question 57. Which sign warrants evaluation for heterotopic ossification after severe TBI?

  1. Painful warmth and progressive loss of hip range
  2. Transient hiccups alone
  3. Improved range of motion
  4. Isolated visual blurring
Reveal correct answer and explanation

Correct answer: A. Painful warmth and progressive loss of hip range

Neurogenic heterotopic ossification may present with warmth, swelling and painful motion restriction around large joints.

Question 58. Before providing oral feeding to a severe TBI survivor with coughing on water, the team should:

  1. Arrange dysphagia assessment and appropriate swallow testing
  2. Begin unrestricted thin liquids
  3. Ignore cough if alert
  4. Use a blind finger sweep
Reveal correct answer and explanation

Correct answer: A. Arrange dysphagia assessment and appropriate swallow testing

Dysphagia assessment helps prevent aspiration, dehydration and malnutrition.

Question 59. A patient with memory impairment after TBI repeatedly forgets appointments. A practical evidence-supported compensatory approach is:

  1. External memory aids and trained routines
  2. Demanding immediate unaided recall alone
  3. Avoiding all reminders
  4. Withholding family education
Reveal correct answer and explanation

Correct answer: A. External memory aids and trained routines

Calendars, alarms and notebooks can compensate for functional memory problems when trained in everyday contexts.

Question 60. Which domain is primarily affected when a patient cannot plan a multistep task despite preserved basic strength?

  1. Executive functioning
  2. Visual acuity
  3. Deep tendon reflexes
  4. Nociception only
Reveal correct answer and explanation

Correct answer: A. Executive functioning

Executive dysfunction includes difficulties with planning, initiation, organization, monitoring and inhibition.

Question 61. For attention deficits following moderate-to-severe TBI, a useful rehabilitation approach is:

  1. Graded attention training tied to functional tasks
  2. Permanent sensory isolation
  3. Only passive limb stretches
  4. Routine sedating medication as first-line
Reveal correct answer and explanation

Correct answer: A. Graded attention training tied to functional tasks

Evidence-informed attention rehabilitation uses structured, progressively challenging tasks and functional generalization.

Question 62. Which professional commonly leads formal assessment of aphasia and cognitive-communication disorders after TBI?

  1. Speech-language pathologist
  2. Orthopedic technician exclusively
  3. Radiographer exclusively
  4. Dialysis nurse exclusively
Reveal correct answer and explanation

Correct answer: A. Speech-language pathologist

Speech-language therapy evaluates language, pragmatic communication and swallowing alongside the team.

Question 63. Which deficit best exemplifies impaired social cognition after TBI?

  1. Difficulty recognizing another person's emotional cues
  2. Weak quadriceps contraction
  3. Reduced ankle dorsiflexion
  4. Elevated serum glucose
Reveal correct answer and explanation

Correct answer: A. Difficulty recognizing another person's emotional cues

Emotion recognition and theory-of-mind problems can impair relationships and community participation.

Question 64. A patient has prominent fatigue and reduced initiation after frontal injury. Which interpretation is best?

  1. Consider cognitive fatigue, depression, sleep disturbance and medication effects
  2. Assume deliberate noncompliance
  3. Avoid any functional assessment
  4. Diagnose dementia from this symptom alone
Reveal correct answer and explanation

Correct answer: A. Consider cognitive fatigue, depression, sleep disturbance and medication effects

Post-TBI fatigue and reduced initiation are multifactorial and deserve structured assessment.

Question 65. A TBI inpatient repeatedly pulls at lines while disoriented. Which action is most appropriate initially?

  1. Check for pain, retention, delirium, hypoxia and overstimulation
  2. Label the patient permanently aggressive
  3. Give no orientation cues
  4. Stop all monitoring
Reveal correct answer and explanation

Correct answer: A. Check for pain, retention, delirium, hypoxia and overstimulation

Potentially reversible medical or environmental triggers should be considered before escalating interventions.

Question 66. Which sleep-related symptom can materially impede rehabilitation progress after TBI?

  1. Insomnia and fragmented sleep
  2. Normal consolidated sleep
  3. Normal circadian alertness
  4. Stable daytime energy
Reveal correct answer and explanation

Correct answer: A. Insomnia and fragmented sleep

Poor sleep worsens attention, fatigue, mood and participation.

Question 67. Which measure best represents independence in basic daily activities during rehabilitation?

  1. Functional Independence Measure or similar standardized ADL assessment
  2. Glasgow Coma Scale only
  3. Serum sodium
  4. Skull circumference
Reveal correct answer and explanation

Correct answer: A. Functional Independence Measure or similar standardized ADL assessment

Functional measures assess assistance requirements for self-care, mobility and cognition, complementing acute severity scores.

Question 68. A patient can walk independently but makes unsafe decisions after TBI. Which statement is correct?

  1. Mobility alone does not establish safe independent living
  2. Independent gait proves full cognitive recovery
  3. No caregiver counseling is needed
  4. The patient is automatically fit to drive
Reveal correct answer and explanation

Correct answer: A. Mobility alone does not establish safe independent living

Executive dysfunction, impaired awareness and judgment affect risk despite restored strength.

Question 69. Who is best placed to assess readiness for return to driving after TBI?

  1. A trained multidisciplinary or specialist driving evaluation service where available
  2. Family reassurance alone
  3. A normal leg-strength test only
  4. GCS on the admission day alone
Reveal correct answer and explanation

Correct answer: A. A trained multidisciplinary or specialist driving evaluation service where available

Vision, cognition, attention, behavior, motor abilities and local licensing requirements all matter.

Question 70. Which approach best reflects vocational rehabilitation after TBI?

  1. Individualized graded return with task and workplace accommodations
  2. Immediate full-time return without assessment
  3. Avoiding employer discussions when consented
  4. Only upper-limb stretching
Reveal correct answer and explanation

Correct answer: A. Individualized graded return with task and workplace accommodations

Job analysis, graded hours, cognitive strategies and accommodations support sustainable work participation.

Question 71. Late enlargement of ventricles with gait and cognition decline after TBI raises concern for:

  1. Post-traumatic hydrocephalus
  2. Isolated muscle strain
  3. Simple concussion without complications
  4. Carpal tunnel syndrome
Reveal correct answer and explanation

Correct answer: A. Post-traumatic hydrocephalus

Hydrocephalus is potentially treatable; interpretation must distinguish it from ventriculomegaly due to atrophy.

Question 72. Which outcome best captures community participation rather than only body impairment?

  1. Resuming family, social and vocational roles
  2. Biceps reflex amplitude
  3. One-time ICP measurement
  4. Passive ankle angle alone
Reveal correct answer and explanation

Correct answer: A. Resuming family, social and vocational roles

Participation is a core rehabilitation outcome distinct from impairment-level measures.

Question 73. Which statement about mild TBI and concussion is accurate?

  1. A normal CT does not exclude concussion
  2. All concussions show a large CT hemorrhage
  3. Loss of consciousness is always required
  4. Concussion always causes lifelong disability
Reveal correct answer and explanation

Correct answer: A. A normal CT does not exclude concussion

Concussion is a clinical diagnosis and conventional imaging is commonly normal.

Question 74. A patient develops worsening headache, repeated vomiting and confusion after an initial mild TBI evaluation. Best action?

  1. Urgent reassessment for intracranial complication
  2. Reassure without review
  3. Recommend vigorous exercise
  4. Wait several weeks for routine follow-up
Reveal correct answer and explanation

Correct answer: A. Urgent reassessment for intracranial complication

New or progressive red flags necessitate prompt reassessment and potentially neuroimaging.

Question 75. Which symptom is common after concussion?

  1. Headache with light sensitivity and impaired concentration
  2. Profound hemiplegia in every case
  3. Persistent blown pupil as benign finding
  4. Mandatory skull fracture
Reveal correct answer and explanation

Correct answer: A. Headache with light sensitivity and impaired concentration

Somatic, vestibular, cognitive and emotional symptoms may follow concussion.

Set 4: Questions 76–100

Question 76. The most appropriate approach to persistent dizziness after concussion is:

  1. Assess vestibular, ocular and cervical contributors and target therapy
  2. Assume it is always psychogenic
  3. Prescribe permanent bed rest
  4. Ignore balance findings
Reveal correct answer and explanation

Correct answer: A. Assess vestibular, ocular and cervical contributors and target therapy

Vestibular/ocular assessment can direct specific rehabilitation and exclusion of central red flags.

Question 77. Which is a key difference between post-traumatic epilepsy and an early provoked seizure?

  1. Epilepsy relates to enduring predisposition to unprovoked seizures
  2. Every seizure within 24 hours proves epilepsy
  3. Late seizures never occur
  4. Antiseizure prophylaxis eliminates all future epilepsy
Reveal correct answer and explanation

Correct answer: A. Epilepsy relates to enduring predisposition to unprovoked seizures

An early seizure is an acute symptomatic event; late unprovoked seizures can indicate enduring epileptogenic risk.

Question 78. In a patient receiving mannitol or hypertonic saline, which parameter needs active monitoring?

  1. Electrolytes, osmolality and renal/hemodynamic status
  2. Hair color
  3. Pupil color only
  4. Height alone
Reveal correct answer and explanation

Correct answer: A. Electrolytes, osmolality and renal/hemodynamic status

Hyperosmolar therapies require monitoring for sodium disorders, renal dysfunction and circulatory effects.

Question 79. Which condition can cause neurologic worsening during the first days after contusion?

  1. Hemorrhagic progression and edema
  2. Instant disappearance of all lesions
  3. Only delayed skull calcification
  4. Peripheral neuropathy exclusively
Reveal correct answer and explanation

Correct answer: A. Hemorrhagic progression and edema

Contusions can blossom and edema can increase, motivating serial neurological evaluation.

Question 80. Why is intensive cerebral perfusion monitoring relevant after severe TBI?

  1. Hypotension and high ICP can cause secondary ischemia
  2. Primary injury is reversible by monitoring alone
  3. Cerebral blood flow is independent of pressure
  4. ICP and MAP have no relationship
Reveal correct answer and explanation

Correct answer: A. Hypotension and high ICP can cause secondary ischemia

CPP represents the pressure gradient driving cerebral perfusion, although autoregulation modifies flow.

Question 81. In a patient with refractory ICP elevation, which intervention can reduce intracranial volume mechanically?

  1. Decompressive craniectomy in selected cases
  2. Oral antibiotics alone
  3. Passive exercise alone
  4. Routine lumbar puncture
Reveal correct answer and explanation

Correct answer: A. Decompressive craniectomy in selected cases

Cranial decompression may control refractory intracranial hypertension; patient selection and functional outcome tradeoffs are critical.

Question 82. What is the correct goal for routine early prophylactic anticoagulation decisions after TBI?

  1. Balance venous thromboembolism prevention against hemorrhage stability
  2. Give thrombolytic therapy to every patient
  3. Avoid VTE assessment entirely
  4. Start full-dose anticoagulation indiscriminately
Reveal correct answer and explanation

Correct answer: A. Balance venous thromboembolism prevention against hemorrhage stability

Timing depends on stability of intracranial bleeding, injury severity and neurosurgical guidance.

Question 83. An older TBI survivor is experiencing falls because of inattention and poor dual-task gait. Best rehabilitation plan?

  1. Combine gait/balance training with graded cognitive dual-task practice and safety strategies
  2. Prescribe walking alone on unsafe terrain
  3. Use only bed rest
  4. Ignore cognitive deficits
Reveal correct answer and explanation

Correct answer: A. Combine gait/balance training with graded cognitive dual-task practice and safety strategies

Integrated mobility and attention training with graded challenge addresses real-world fall risk.

Question 84. A survivor has poor self-awareness of deficits and rejects safety precautions. Best strategy?

  1. Structured feedback, goal-setting and caregiver-supported monitoring
  2. Assume intact insight because speech is fluent
  3. Immediate unsupervised discharge
  4. Stop rehabilitation
Reveal correct answer and explanation

Correct answer: A. Structured feedback, goal-setting and caregiver-supported monitoring

Impaired self-awareness can undermine adherence and safety; metacognitive intervention may help.

Question 85. Which tool best maps progress from acute TBI severity to later disability?

  1. Use GCS acutely and GOSE for follow-up function
  2. Repeat only admission GCS for years
  3. Use an isolated serum marker
  4. Use only skull X-ray
Reveal correct answer and explanation

Correct answer: A. Use GCS acutely and GOSE for follow-up function

Acute severity and long-term functional outcome are distinct domains requiring different instruments.

Question 86. A patient after severe TBI develops fever and worsening spasticity. Initial rehabilitation reasoning should prioritize:

  1. Search for infection, pain and other noxious triggers
  2. Escalate antispastic medication without examination
  3. Assume irreversible neurologic progression
  4. Discharge immediately
Reveal correct answer and explanation

Correct answer: A. Search for infection, pain and other noxious triggers

Infection, constipation, urinary retention and pain can trigger increased tone and autonomic dysregulation.

Question 87. Early rehabilitation referral in medically stable severe TBI is important because:

  1. Function, swallowing, positioning and family needs can be addressed alongside acute treatment
  2. Rehabilitation must wait until full consciousness
  3. It replaces neurocritical monitoring
  4. It removes need for nursing care
Reveal correct answer and explanation

Correct answer: A. Function, swallowing, positioning and family needs can be addressed alongside acute treatment

Early multidisciplinary rehabilitation supports prevention and recovery without superseding physiologic safety.

Question 88. The most appropriate management of a patient who is minimally conscious and has severe limb contracture risk is:

  1. Multidisciplinary positioning and regular reassessment of consciousness and range
  2. Assume rehabilitation has no role
  3. Use only maximal intensity strengthening
  4. Avoid caregiver education
Reveal correct answer and explanation

Correct answer: A. Multidisciplinary positioning and regular reassessment of consciousness and range

DoC care includes standardized repeated assessment and prevention of secondary musculoskeletal complications.

Question 89. A patient after frontal TBI becomes impulsive and gives socially inappropriate responses. Principal affected system?

  1. Executive and behavioral regulation networks
  2. Pure vestibular reflex arc
  3. Peripheral neuromuscular junction
  4. Dorsal column sensory pathways exclusively
Reveal correct answer and explanation

Correct answer: A. Executive and behavioral regulation networks

Frontal-subcortical network injury can impair inhibition, decision-making and social behavior.

Question 90. Which symptom cluster raises concern for neurogenic bladder complications in a dependent TBI patient?

  1. Retention, recurrent urinary infections and incontinence
  2. Improving bowel regularity only
  3. Normal post-void residual
  4. Stable continence
Reveal correct answer and explanation

Correct answer: A. Retention, recurrent urinary infections and incontinence

Bladder assessment can identify retention, infection and practical continence needs.

Question 91. In a medically stable TBI patient with early orthostatic hypotension, the safest approach is:

  1. Graded upright tolerance training with blood pressure monitoring
  2. Immediate unsupervised standing for an hour
  3. Avoid all future mobilization
  4. Ignore dizziness
Reveal correct answer and explanation

Correct answer: A. Graded upright tolerance training with blood pressure monitoring

Progressive head-up positioning and hemodynamic observation reduce syncope risk during mobilization.

Question 92. Which patient-centered goal is most appropriate for rehabilitation planning?

  1. Independently transfer from bed to chair with safe technique
  2. Normalize every scan by tomorrow
  3. Guarantee no future cognitive symptoms
  4. Avoid measuring function
Reveal correct answer and explanation

Correct answer: A. Independently transfer from bed to chair with safe technique

Specific measurable functional goals guide interdisciplinary treatment and reassessment.

Question 93. What distinguishes a multidisciplinary TBI rehabilitation team from isolated physical therapy?

  1. Coordinated mobility, cognition, communication, self-care and psychosocial care
  2. Only exercise repetition
  3. Avoidance of family meetings
  4. No standardized outcome measures
Reveal correct answer and explanation

Correct answer: A. Coordinated mobility, cognition, communication, self-care and psychosocial care

Team rehabilitation integrates physiatry, PT, OT, SLP, psychology, nursing and social services.

Question 94. For cognitive rehabilitation, what is meant by generalization?

  1. Applying a learned strategy beyond the training task to real situations
  2. Memorizing test answers only
  3. Improving only the practiced computer score
  4. Ignoring everyday participation
Reveal correct answer and explanation

Correct answer: A. Applying a learned strategy beyond the training task to real situations

Transfer of training to real-world tasks is central to clinically useful rehabilitation.

Question 95. Which feature is a more appropriate marker of readiness to leave inpatient rehabilitation?

  1. Safe function with feasible supports and a coordinated follow-up plan
  2. Normal CT only
  3. Absence of every symptom
  4. Age under 50
Reveal correct answer and explanation

Correct answer: A. Safe function with feasible supports and a coordinated follow-up plan

Disposition considers current assistance needs, caregiver capacity, risks and access to continuing care.

Question 96. A patient develops persistent excessive daytime sleepiness several months after TBI. What is appropriate?

  1. Assess sleep disorders, medicines, mood and endocrine contributors
  2. Assume the complaint is malingering
  3. Prescribe lifelong sedatives automatically
  4. Ignore impact on driving
Reveal correct answer and explanation

Correct answer: A. Assess sleep disorders, medicines, mood and endocrine contributors

Sleep-wake disturbance after TBI is multifactorial; assessment targets reversible causes and functional consequences.

Question 97. Which statement regarding return to sport after concussion is correct?

  1. Return should be staged and medically guided, with no contact risk during persisting concerning symptoms
  2. Immediate same-day return is always acceptable
  3. Prolonged absolute rest is universally required
  4. Symptom recurrence must always be ignored
Reveal correct answer and explanation

Correct answer: A. Return should be staged and medically guided, with no contact risk during persisting concerning symptoms

A graduated, individualized return-to-sport protocol reduces risks of premature collision exposure.

Question 98. In a patient after TBI with poor insight, what increases the reliability of function assessment?

  1. Combining patient report with observed performance and appropriate collateral history
  2. Patient self-report alone always
  3. Using only the initial CT
  4. Avoiding real-world task observation
Reveal correct answer and explanation

Correct answer: A. Combining patient report with observed performance and appropriate collateral history

Performance-based assessment and information from informed caregivers help characterize function where awareness is impaired.

Question 99. A TBI patient has difficulty managing medications despite intact motor strength. Which service is central to functional intervention?

  1. Occupational therapy with cognitive strategy training
  2. Only lower-limb stretching
  3. Orthopedic casting
  4. Isolated visual acuity testing
Reveal correct answer and explanation

Correct answer: A. Occupational therapy with cognitive strategy training

OT can assess instrumental ADLs and build compensatory systems for safe medication management.

Question 100. Which long-term endpoint is MOST consistent with a rehabilitation perspective on TBI?

  1. Meaningful independence and participation compatible with individual goals
  2. CT normalization alone
  3. Absolute freedom from all fatigue
  4. A single motor score exclusively
Reveal correct answer and explanation

Correct answer: A. Meaningful independence and participation compatible with individual goals

Successful rehabilitation targets activities, participation, safety and quality of life, not only lesion appearance.

Educational Content Only. Clinical decisions must follow current institutional protocols and specialist assessment.

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Detailed Answer Review

100 MCQ on Traumatic Brain injury

Experience NEET-like Computer-Based Practice 100 MCQ on Traumatic Brain injury

1: For whom it is

  • NEET PG aspirants
  • Students trying for other post graduate Medical/Healthcare Entrance Examinations
  • PMR/rehabilitation Medicine Enthusiast

Note These MCQ covers Traumatic Brain injury

2: 100 MCQ on Traumatic Brain injury – It’s FREE

  • Click “Start MCQ” on the above block
  • NEET PG Based MCQ also included

3: Answer 25 Multiple-Choice Questions in each Set

  • Single best answer per question.
  • Each correct answer carries 4 point.
  • 20-minute fixed time limit for 25 MCQ.
  • Negative Markings -1.

4: Colour Code in Review Panel

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6: Results

  • See your Score.
  • Tabulated results with questions, answers and explanations.
  • Audio effects enhance user experience (not part of NEET interface).

7: Topics Covered in 100 MCQs on Traumatic Brain Injury

  • Glasgow Coma Scale (GCS): components, scoring, severity classification and limitations.
  • Primary and secondary brain injury: mechanisms and preventable secondary insults.
  • Diffuse axonal injury (DAI): mechanisms, anatomical distribution and MRI findings.
  • Epidural and subdural hematomas: clinical features, vascular sources, CT findings and management.
  • Traumatic subarachnoid hemorrhage, cerebral contusions and coup–contrecoup injuries.
  • Skull fractures: temporal bone injury, depressed fractures, basal skull fractures and clinical signs.
  • Intracranial pressure (ICP), cerebral perfusion pressure (CPP) and the Monro–Kellie doctrine.
  • Brain herniation: pupillary changes, anisocoria and Cushing response.
  • Emergency evaluation: airway protection, cervical spine precautions and neurological monitoring.
  • Neuroimaging: CT and MRI interpretation, indications for repeat imaging and recognition of complications.
  • Acute TBI management: hyperosmolar therapy, ventilation strategies and avoidance of corticosteroids.
  • Neurosurgical management: indications for hematoma evacuation and decompressive craniectomy.
  • Post-traumatic seizures and epilepsy: early versus late seizures.
  • Disorders of consciousness: coma, unresponsive wakefulness syndrome and minimally conscious state.
  • Neurological assessment scales: FOUR score and Coma Recovery Scale–Revised (CRS-R).
  • Post-traumatic amnesia and cognitive recovery assessment.
  • Rancho Los Amigos Levels of Cognitive Functioning.
  • Early rehabilitation: medical stability, mobilization and prevention of complications.
  • Spasticity, contractures and heterotopic ossification following TBI.
  • Paroxysmal sympathetic hyperactivity and autonomic complications.
  • Dysphagia assessment and swallowing rehabilitation.
  • Cognitive rehabilitation: attention, memory, executive function and compensatory strategies.
  • Behavioral and neuropsychiatric complications: agitation, impulsivity, poor insight and social cognition.
  • Sleep disturbances, fatigue and excessive daytime sleepiness.
  • Motor rehabilitation: balance, gait, dual-task training and fall prevention.
  • Mild TBI and concussion: symptoms, warning signs, persistent dizziness and return-to-sport decisions.
  • Post-traumatic hydrocephalus and delayed neurological deterioration.
  • Functional assessment: activities of daily living, disability and rehabilitation outcomes.
  • Occupational therapy, return to driving, vocational rehabilitation and community participation.
  • Multidisciplinary rehabilitation, individualized goal-setting and discharge planning.

8: Queries

Contact: contact@sensingmedicine.com

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Physical Medicine & Rehabilitation
FAQs

What is Physical Medicine and Rehabilitation?

Physical Medicine and Rehabilitation (PM&R), also known as physiatry, is an allopathic medical specialty that involves restoring function for a person who has been disabled by disease, disorder, or injury. It provides integrated, multidisciplinary care addressing physical, emotional, medical, vocational, and social needs.

Who is a “Physiatrist”?

A physiatrist is a physician specializing in physical medicine and rehabilitation. (In India: MBBS followed by MD/DNB in PMR.)

What is Rehabilitation?

Rehabilitation is the process of helping a person achieve the highest level of function, independence, and quality of life possible. It does not undo damage but restores optimal health, functioning, and well-being.

Is PM&R only for people with disabilities?

No. PM&R serves anyone experiencing a decline in physical function—from athletes with injuries to elderly individuals recovering from surgery, falls, or pain.

Can physiatrists perform surgery?

Yes. In India, physiatrists perform rehabilitation surgeries such as deformity corrections, tendon transfers, and revision of amputations.

How does PM&R help in managing chronic pain?

Physiatrists use a multimodal approach—evaluation, diagnosis, medication, therapy, injections (e.g., nerve blocks, trigger point/joint injections), and lifestyle modifications—to reduce pain and improve daily function.

What conditions do physiatrists treat?

Common conditions include stroke, spinal cord injuries, traumatic brain injury, cerebral palsy, amputations, sports injuries, chronic musculoskeletal pain, post-surgical rehabilitation, osteoarthritis, osteoporosis, and more.

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