A 64-year-old woman slips and falls on an icy sidewalk. She hits the side of her head on the curb. After a momentary loss of consciousness she recovers, but is in some pain. Fifteen minutes later her level of consciousness begins to fluctuate and she is brought to the emergency room comatose. Magnetic resonance imaging (MRI) of the patient’s head within the first few hours of injury should reveal which of the following?
a. A normal brain
b. Intracerebral hematoma
c. Temporal lobe contusion
d. Subarachnoid hemorrhage
e. Epidural hematoma
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care. Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is e; Epidural hematoma.
The history is typical for an epidural hematoma. Damage to the middle meningeal artery allows blood at arterial pressures to dissect in the potential space that exists between the dura mater and the periosteum of the skull. With MRI, the epidural hematoma should be evident soon after the injury, and will certainly be evident by the time the patient is symptomatic.