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Whiplash / Neck Pain

CAD Quiz #5

Arthur Croft, DC, MS, MPH, FACO

So, you passed the last quiz (#4). Congratulations. Now it might be nice to see if you are consistent or just a lucky guesser. Here is another CAD (cervical acceleration/deceleration - whiplash) quiz to test your knowledge.

1. Cars today have bumpers that are rated at either 2.5 mph or 5 mph, depending on the year of manufacture. Which statement is true concerning these bumpers?

  1. A 5 mph rated bumper can withstand only a 5 mph crash before it becomes damaged.
  2. A 2.5 mph rated bumper will be damaged in crashes exceeding 2.5 mph.
  3. The rating is not a reliable gauge of the speed-related damage threshold because nondamage-producing crash speeds well above the rating are possible.
  4. This rating is one of the Federal Motor Vehicle Safety Standards.

2. Which of the following is not a known risk factor for injury in CAD?
  1. Crash speed change (delta V) under 10 mph.
  2. Rear impact vector vs. other vectors (e.g., frontal, roll-over, side impact).
  3. Impact with a vehicle of greater mass.
  4. Diabetes.

3. Which of the following is not a known risk factor for poor outcome in CAD?
  1. Female gender.
  2. Sitting in the rear seat vs. the front.
  3. Immediate onset of symptoms.
  4. Initial neurological symptoms.

4. According to the epidemiological literature, the approximate risk for injury in a low-speed rear impact crash (3-7 mph delta V) is:
  1. Nearly 100%.
  2. About 60-80%.
  3. About 25%.
  4. About 35-50%.

5. Outcome studies have consistently demonstrated that the outcome for those injured in rear impact vector crashes is worse that for those injured in frontal or side impact crashes. They show the mean percentage of chronicity in this (rear impact) subgroup to be:
  1. About 12%.
  2. About 55%.
  3. About 84%.
  4. About 95%.

6. The proportion of disability arising from CAD injury is most often cited as being:
  1. About 10%.
  2. About 18%.
  3. About 25%.
  4. About 50%.

7. For patients complaining of vertigo, the clinical examination procedure of choice would be:
  1. Electronystagmography (ENG).
  2. The Nylen-Hallpike maneuver.
  3. Moving platform posturography (MPP).
  4. The Breathalyzer test.

8. CAD patients reporting vertigo following rapid head position changes are probably suffering from:
  1. Acute alcohol intoxication.
  2. Benign postural vestibular dysplasia (BPVD).
  3. Malignant vestibular disturbance (MVD).
  4. Benign positional paroxysmal vertigo (BPPV).

9. For the condition described in #8, the treatment reported to have a 75-85% effectiveness is:
  1. Surgical closure of the round window.
  2. The particle-repositioning maneuver.
  3. A strict no-fat diet.
  4. Convergent hyperconditioning.

10. The term double crush describes:
  1. A crash scenario in which a vehicle is struck from two sides or directions in the same crash.
  2. A neurological condition in which clinical symptoms are thought to be the result of the cumulative effects of compression at two anatomically different locations of one nerve.
  3. A type of fracture or other injury resulting from being driven over by the two wheels of a car or other vehicle.
  4. None of the above is correct.

Correct Answers:
  1. C
  2. D
  3. B
  4. D
  5. B
  6. A
  7. B
  8. D
  9. B
  10. B
How do you stack up?

If you scored 9-10: You're an expert. We need more like you.
If you scored 7-8: You're still above average. You're well read (or taught).
If you scored 5-6: Average. You call yourself an expert? You need to brush up.
If you scored 3-4: Poor. You're not even a good guesser. Chance alone nearly guarantees you a score of 2-3! If you're treating these people, you definitely need to get current.

Arthur Croft,DC,MS,FACO,FACFE
Director, Spine Research Institute of San Diego
San Diego, California
drcroft@san.rr.com

May 2000
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