Sometimes, just the mere thought of taking an exam is enough to cause a reaction. There are physical reactions, such as tremors in the hands or sickness. There are also cognitive reactions, such as memory loss and an inability to write as they normally would. This means that both the exam and the preparation suffer. These symptoms may be mild, perhaps only building during long study sessions or difficult subjects. Others deal with extreme exam anxiety at the mere mention of an examination. The additional problem is that some students may try and hide the problem, forcing themselves into deeper study and worsening the issue. This could lead to medical problems like insomnia or poor immunity. Some may miss days of school, potentially worsening the situation further.
Anxiety then continues to build as students consider the consequences of a poor performance. They may have to repeat the year if they fail to achieve the required grade. This would extend their time in a difficult educational system, and take them away from their peers. They may also fail to achieve the college place they wanted. This could have knock-on implications for their career and plan on where they relocate to study. This anxiety can lead to again lead to some serious medical complications. Some may miss the exam completely due to ill health.