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Epidural hematoma — USMLE Step 2 CK MCQ

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ModerateSurgeryEpidural hematomaUSMLE Step 2 CK

A 33-year-old Hispanic woman comes to the emergency department because of progressive symptoms. History and focused examination are notable for brief loss of consciousness, lucid interval, and biconvex temporal hemorrhage. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely cause of this patient's condition?

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Correct answer: E — Middle meningeal artery rupture after temporal bone trauma

The vignette describes Epidural hematoma, supported by brief loss of consciousness, lucid interval, and biconvex temporal hemorrhage. Middle meningeal artery rupture after temporal bone trauma is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-91