Archive Of Standardized Exam Questions: Epidural Hematoma

OVERVIEW

This page is dedicated to organizing various examples of standardized exam questions whose answer is epidural hematoma. While this may seem a odd practice, it is useful to see multiple examples of how epidural hematoma will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.

KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)

When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for epidural hematoma

  • “Lens-shaped” collection of blood can be seen on head imaging  
QUESTION EXAMPLES

Question # 1

A 3 year old boy is brought to the hospital because he has been vomiting for the past day. He also has appeared more lethargic for the past few hours. Earlier that day he fell and hit the side of his on a coffee table while playing with his sister in the living room. He did not lose consciousness after hitting his head. The vomiting began about 3 hours after he struck his head. When he arrives to the emergency room he appears sleepy but is oriented. His pulse is 80/min, blood pressure is 100/60 mm Hg. There is a 3 cm round area of swelling over the right parental bone, and it is soft to the touch. Funduscopic exam is unremarkable. A CT scan shows a lens-shaped extra cerebral density that is found directly beneath the parietal swelling. What is the most likely diagnosis?

Explanation # 1

History of head trauma + lens-shaped signal on CT scan = epidural hematoma

Question # 2

A 7 year old male child is brought to the hospital about half an hour after being involved in a traffic collision. When he arrives he is awake and alert. There is a clear scalp laceration over the left frontoparietal region. No neurological deficits are appreciated on a neurological exam. A CT scan shows a linear temporal skull fracture. What other finding would be very likely on this scan?

Explanation # 2 

Temporal skull fracture often causes an epidural hematoma

Question 3

A 15-year-old male is hit over the left side of the head with a tennis racket. He loses consciousness for 5 minutes, but recovers promptly and continues to play. One hour later he is found unconscious. His left pupil is fixed and dilated.

Explanation # 3

 

TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)

Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:

  • Most common artery responsible: middle meningeal artery 

 

Page Updated: 11.19.2016