What factors are associated with recovery in pediatric patients with mild traumatic brain injury or concussion?

A student’s recovery period may be influenced by:A. Learning disabilitiesB. Prior concussionsC. History of headachesD. B and CE. All of the above

It is best to implement few learning accommodations when a student with a concussion first returns to school, and add more accommodations over time as needed.TrueFalse

A 54-year-old female with symptoms of persistent fatigue and impaired cognitive function was examined by her physician.  During the exam, the patient expressed concern over increased body fat and, under questioning, reported having suffered a concussion during a soccer match in college.  Based upon the patient's symptoms and responses to questions, the physician ordered a panel of tests.A concussion is a mild traumatic brain injury (TBI) that results from impact to the skull.  TBI occurs most frequently in male patients, typically due to accidents; however, there is growing appreciation that TBI also occurs in male and female athletes during sporting events.  In addition, previously unrecognized chronic responses to TBI (eg, hormonal deficiencies) are now better understood.As part of the examination, the patient underwent a test to evaluate growth hormone (GH) secretion.  The brain participates in regulating GH secretion, and roughly half of the GH secreted into the blood is bound to a binding protein that increases the half-life of GH by inhibiting its urinary elimination.  Furthermore, lipid-soluble sex hormones, such as estradiol, augment GH secretion.During the GH secretion test, GH-releasing hormone (GHRH) was administered to the patient along with arginine.  GHRH is an endogenous stimulator of GH secretion, and arginine inhibits secretion of somatostatin, an endogenous inhibitor of GH secretion.  When administered together in healthy individuals, GHRH and arginine strongly stimulate GH secretion into the blood.  However, this patient exhibited an abnormally small response to GHRH and arginine, leading the physician to start the patient on GH therapy.  After a year, the patient's symptoms had improved, and body composition testing showed that her lean body mass had increased. Question 36Based on the passage, a likely mechanism by which GH therapy relieves chronic symptoms associated with TBI is by:A.stimulating protein synthesis in multiple tissues.B.inhibiting protein synthesis in multiple tissues.C.stimulating GHRH release by the pituitary.D.inhibiting GHRH release by the pituitary.

A student with a concussion returns to your class after a week of rest at home. What changes might you notice in the student?A. IrritabilityB. Slow ProcessingC. FatigueD. RestlessnessE. B and DF. All of the above

Check all symptoms that can apply to someone who is experiencing a concussion: Question 1 options: dizziness headache difficulty concentrating/remembering cough/cold drowsiness or difficulty falling asleep depression/irritability