CERTIFIED BRAIN INJURY SPECIALIST (CBIS)
EXAM 2 – COMPLETE EXAM QUESTIONS AND
ANSWERS – FULLY DETAILED AND
PREVIOUSLY PASSED! UPDATED FOR 2025/2026
TESTING CYCLE
Nuerocognitive Issues Assoicated with Frontal Lobe
Emotional control, behavioral control, verbal expression, problem solving, decision making,
social control, attention, motivation
Acquired BI
An injury to the brain that is not hereditary, congenital or degenerative or induced by birth
trauma
TBI
An alteration in brain function or other evidence of brain pathology, casused by an external force
Mild TBI Characteristics
Brief or no loss of consciousness for 0-30mins, altered state of consciousness is most common
and must be <24 hours, account for 75% of TBIs, 13-15 on the GCS, normal imaging, highest
prevalence of maltreatment as 16-25% never seek care, often considered a concussion
Moderate TBI Characteristics
Loss of consciousness for up to 24 hours, may appear on scans, skull fractures and bleeding are
common, 9-12 on the GCS
Severe TBI Characteristics
Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury
1 BI increases risk of 2nd by 3x and 2nd BI increases risk of 3rd by 8x!
Most Frequent Cause of TBI
Falls
How many people sustain a BI per year?
,2.5 million. 81% visit ED, 16% hsopitalized, 3% result in death
How many people are living with effects of a TBI?
13.5 million
Likelihood of BI by gender
Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+
Falls!
Most common cause of TBI and death by age - 0-3
AHT!
Most common cause of TBI and death by age - 20-24
MVAs and Firearms
Most common cause of TBI and death by age - 16-19
MVAs!
CARF
Accreditation agency for post acute BI programs, residential, outpatient, vocational, home and
community, stroke and pediatric programs - ensures quality of services through requirements for
accreditation and surveys
Joint Commission
Accreditation agency for hospital based programs, may accompany CARF accreditation, ensures
quality of services through requirements for accreditation and surveys
Olmsted Decison
Supreme court case stimulated by two women living in a nursing home in Georgia for
community inclusion - resulted in federal and state initiatives to improve and normalize
community living
Model Systems of Care 1987
Resulted in research projects for TBI by the NIDDR, established rehab facilities to provide care
and complete clinical research in the process
Symptoms of Mild TBI
, Headache, fatigue, seizures, nausea, numbness, poor sleep, light sensitivity, noise sensitivity,
impaired hearing, blurred vision, dizziness, loss of balance, neurological abnormality, in
attentiveness, decreased concentration, poor memory, impaired judgment, slow proccessing
speed, executive dysfunction, depression, anxiety, agitation, irritability, aggression, impulsivity
Primary causes of Mild TBI
Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI
Relaxation techniques, rest, slow return to normal activity, and reduction of normal activity if
symptoms recur
Peristent Post Concussive Symptoms (PPCS)
Symptoms of Mild TBI last >1 month, occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE)
Often cause by repeated blows to the head, is a progressive, degenerative condition characterized
by broken nuerons which continually release tau protein cashing dementia over time
Diffuse axonal injury -> tau protein release -> inflammation of the brain -> progressive dementia
Define Skull
Bony shell that protects the brain, has bony prominences inside which can worsen brain injury
Cerebral Spinal Fluid (CSF)
Provides cushion to nerve tissue, produced by ventricles (4) which also store and circulation CSF
through the brain
Meninges
Pia Mater - molds around suclhi and gyri, deepest layer
Arachnoid Mater - spiderweb-like, middle layer
Dura Mater - hard plastic, top layer
Nuerons vs Glial Cells
Nuerons communicate electrical impulses throughout brain while Glial cells support and nourish
Nuerons
Synapse
EXAM 2 – COMPLETE EXAM QUESTIONS AND
ANSWERS – FULLY DETAILED AND
PREVIOUSLY PASSED! UPDATED FOR 2025/2026
TESTING CYCLE
Nuerocognitive Issues Assoicated with Frontal Lobe
Emotional control, behavioral control, verbal expression, problem solving, decision making,
social control, attention, motivation
Acquired BI
An injury to the brain that is not hereditary, congenital or degenerative or induced by birth
trauma
TBI
An alteration in brain function or other evidence of brain pathology, casused by an external force
Mild TBI Characteristics
Brief or no loss of consciousness for 0-30mins, altered state of consciousness is most common
and must be <24 hours, account for 75% of TBIs, 13-15 on the GCS, normal imaging, highest
prevalence of maltreatment as 16-25% never seek care, often considered a concussion
Moderate TBI Characteristics
Loss of consciousness for up to 24 hours, may appear on scans, skull fractures and bleeding are
common, 9-12 on the GCS
Severe TBI Characteristics
Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury
1 BI increases risk of 2nd by 3x and 2nd BI increases risk of 3rd by 8x!
Most Frequent Cause of TBI
Falls
How many people sustain a BI per year?
,2.5 million. 81% visit ED, 16% hsopitalized, 3% result in death
How many people are living with effects of a TBI?
13.5 million
Likelihood of BI by gender
Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+
Falls!
Most common cause of TBI and death by age - 0-3
AHT!
Most common cause of TBI and death by age - 20-24
MVAs and Firearms
Most common cause of TBI and death by age - 16-19
MVAs!
CARF
Accreditation agency for post acute BI programs, residential, outpatient, vocational, home and
community, stroke and pediatric programs - ensures quality of services through requirements for
accreditation and surveys
Joint Commission
Accreditation agency for hospital based programs, may accompany CARF accreditation, ensures
quality of services through requirements for accreditation and surveys
Olmsted Decison
Supreme court case stimulated by two women living in a nursing home in Georgia for
community inclusion - resulted in federal and state initiatives to improve and normalize
community living
Model Systems of Care 1987
Resulted in research projects for TBI by the NIDDR, established rehab facilities to provide care
and complete clinical research in the process
Symptoms of Mild TBI
, Headache, fatigue, seizures, nausea, numbness, poor sleep, light sensitivity, noise sensitivity,
impaired hearing, blurred vision, dizziness, loss of balance, neurological abnormality, in
attentiveness, decreased concentration, poor memory, impaired judgment, slow proccessing
speed, executive dysfunction, depression, anxiety, agitation, irritability, aggression, impulsivity
Primary causes of Mild TBI
Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI
Relaxation techniques, rest, slow return to normal activity, and reduction of normal activity if
symptoms recur
Peristent Post Concussive Symptoms (PPCS)
Symptoms of Mild TBI last >1 month, occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE)
Often cause by repeated blows to the head, is a progressive, degenerative condition characterized
by broken nuerons which continually release tau protein cashing dementia over time
Diffuse axonal injury -> tau protein release -> inflammation of the brain -> progressive dementia
Define Skull
Bony shell that protects the brain, has bony prominences inside which can worsen brain injury
Cerebral Spinal Fluid (CSF)
Provides cushion to nerve tissue, produced by ventricles (4) which also store and circulation CSF
through the brain
Meninges
Pia Mater - molds around suclhi and gyri, deepest layer
Arachnoid Mater - spiderweb-like, middle layer
Dura Mater - hard plastic, top layer
Nuerons vs Glial Cells
Nuerons communicate electrical impulses throughout brain while Glial cells support and nourish
Nuerons
Synapse
