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Basilar skull fracture — ABEM Board MCQ

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ModerateTraumaBasilar skull fractureABEM Board

A 54-year-old man arrives after falling from a ladder. Triage acuity is ESI 2; BP 150/88 mm Hg, HR 88/min. He has periorbital ecchymosis, hemotympanum, and clear fluid draining from the nose. GCS is 14 and there is no facial instability. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Basilar skull fracture with CSF rhinorrhea

Battle sign, raccoon eyes, hemotympanum, and CSF rhinorrhea indicate basilar skull fracture.

Reference: ACEP Mild Traumatic Brain Injury clinical policy; ATLS head trauma guidance