OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is subdural hematoma/hemorrhage. While this may seem a odd practice, it is useful to see multiple examples of how subdural hematoma/hemorrhage will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 80 year old male becomes “senile” over the period of a month. He used to be a very sharp individual, and managed all of his own financial affairs. Currently he just stares out the window, barely talks, and sleeps for most of the day. His son comments that he fell off of a horse about 1 week before all of these changes began.
Explanation: elderly patient + sharp cognitive decline + semi-recent history of mild trauma = subdural hematoma/hemorrhage
Question #2
A 75 year old male is brought to the urgent care by his daughter who is concerned about a recent mental decline in the past few weeks. She explains that he has been getting forgetful for the past few years, however recently has had a very sharp dip in mental capacity. He fell from a step stool about 3 weeks ago, however was not sent to the hospital because he had no obvious injuries. In the last 2 weeks he has declined to the point that he can not care for himself anymore. She found him the other day with his whole house in disarray. Currently he is awake, somnolent, and not oriented. His vital care within normal limits, and there are no focal neurological defects. A mental status exam demonstrates impaired memory, and he scored a 7 out of 30 on the mini-mental status exam. What is the likely cause of this patient’s symptoms?
Explanation: elderly patient + sharp cognitive decline + semi-recent history of mild trauma = subdural hematoma/hemorrhage
Question #3
A 55 year old man is brought to the ER because he has altered cognition. His past medical history is notable for an aortic valve repair, and he is on coumadin. He was installing a new gutter system for his house 4 days ago when he fell form a ladder. He did not lose consciousness and did not go to the hospital because he felt “fine”. Since then he had noticed the development of a headache that was minimally controlled with acetaminophen. Yesterday his brother noticed that he was getting more forgetful, and was getting distracted from his house work very easily. Early this morning he wake and was slurring his words and could not walk without assistance. His vitals are normal. His physical exam is notable for dysarthria, ataxic gait, but there are no focal neurological findings. A CT scan is ordered. What is the likely diagnosis in this patient?
Explanation: anticoagulation + sharp cognitive decline + semi-recent history of mild trauma = subdural hematoma/hemorrhage
Question #4
A 12 year old male with hemophilia A is brought to the clinic because he has been having many headaches, and he is starting to fall behind in school. 2 weeks ago he fell 10 feet off the jungle gym. He did not lose consciousness at the time and remembers striking his head. A CT scan was performed at the time of the fall and was unremarkable. A physical exam today shows bilateral papilledema and hyperrefelxia on the right. Vital signs are unremarkable. What is the likely diagnosis?
Explanation: bleeding disorder + cognitive decline + semi-recent history (2 weeks ago) of mild trauma= subdural hematoma/hemorrhage
Page Updated: 03.06.2017