Injuries: ectopic bruise: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Injuries: ectopic bruise

Sample item

A man struck on the forehead with a blunt object develops a black eye on the same side 24 hours later. Skull radiographs and CT show no fracture, and the orbit was not hit. Which explanation is most appropriate?

AAn ectopic bruise, from blood tracking down tissue planes under gravityBA direct blow to the orbit that was not reportedCA fracture of the anterior cranial fossa that CT has missedDA bleeding disorder causing spontaneous periorbital haemorrhage

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. An ectopic bruise, from blood tracking down tissue planes under gravity

Blood from a deep bruise or haematoma can travel along fascial planes and appear at a site distant from the impact, producing an ectopic or migratory bruise. A forehead blow commonly produces a periorbital ecchymosis after a day because blood gravitates into the loose eyelid tissues. The lack of a direct orbital blow and fracture supports this.

Option by option

A. An ectopic bruise, from blood tracking down tissue planes under gravity (correct)
Correct. Blood tracking through loose tissue planes explains a bruise away from the site of impact.
B. A direct blow to the orbit that was not reported
The history and findings show the blow was to the forehead, so a direct orbital blow is not supported.
C. A fracture of the anterior cranial fossa that CT has missed
Fractures of the anterior fossa typically give bilateral periorbital ecchymosis, and CT showed none.
D. A bleeding disorder causing spontaneous periorbital haemorrhage
A single post-traumatic bruise on the same side as the blow does not suggest a systemic coagulopathy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, An ectopic bruise, from blood tracking down tissue planes under gravity. Blood from a deep bruise or haematoma can travel along fascial planes and appear at a site distant from the impact, producing an ectopic or migratory bruise.

Why is "A direct blow to the orbit that was not reported" not the answer?

The history and findings show the blow was to the forehead, so a direct orbital blow is not supported.

Why is "A fracture of the anterior cranial fossa that CT has missed" not the answer?

Fractures of the anterior fossa typically give bilateral periorbital ecchymosis, and CT showed none.

Why is "A bleeding disorder causing spontaneous periorbital haemorrhage" not the answer?

A single post-traumatic bruise on the same side as the blow does not suggest a systemic coagulopathy.

What concept does this question test?

It tests Injuries: ectopic bruise in Forensic Medicine. A forehead blow commonly produces a periorbital ecchymosis after a day because blood gravitates into the loose eyelid tissues. The lack of a direct orbital blow and fracture supports this.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries: ectopic bruise?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.