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NBME 20 Answers

nbme20/Block 4/Question#30 (29.6 difficulty score)
A 32-year-old woman is brought to the ...
Arterial lacerationπŸ”

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submitted by monoloco(132),
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Aimtney uoy hvae a nproes woh mpsub ehrit h,ade tesg akcb up, nad nthe sah eevrse esiuss ro sdie leik 6 ruohs etarl -- ouy veah yrfesluo an udlaipre mhotaaem rmof inraatcleo to eth mledid IENAMLGEN yerar.t Gnlaj(o rlaely hspizeesam ttha you 'todn screw up and eclset dlmdie albr)r.eec Yuo wkon it hsa ot eb na ertaiarl caanltiroe inces het udar si lgihtty edehrda ot hte lus'ksl rinen scua.erf jGaonl edrfrere to sih ecxprnieee hiwt it sa iendegn reislp to eeovrm eth ruda fmor eth lsluk; icgpr,ha utb it sedvri the iotpn o.meh enTntgi sene no TC si ecbseau eth daiperul meaotmah gtes utcsk etweenb het esuutr hneW ti neasagm to rbaek stap eon of eht ureust n,iels ti si my nnsdritaegudn thta hnte si wnhe oyu etg reseve ,uaseeeql liek adeht or rawv.eeth

usmile1  omg monoloco!! I miss you dude! We used to hang forever ago, hope all is going well in med school! +9  

submitted by misterdoctor69(40),

To add on, a trauma to the skull => middle meningeal artery laceration => epidural hematoma. Epidural hematomas are known to cause transtentorial herniations and CN III palsy, which is what led to the patient's right pupil being dilated and poorly reactive (ipsilateral to the side of trauma).