Injuries: spectacle haematoma: 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: spectacle haematoma

Sample item

A man is brought after a fall from a bike. Over the next 6 hours he develops bilateral periorbital ecchymosis with subconjunctival haemorrhage whose posterior limit cannot be seen. What does this suggest?

ATwo separate direct blows to both eyesBFracture of the anterior cranial fossa with blood tracking into the orbitsCA bleeding disorder causing spontaneous bruisingDFracture of the mandibular condyle

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

The answer and the reasoning

B. Fracture of the anterior cranial fossa with blood tracking into the orbits

Bilateral periorbital ecchymosis (raccoon eyes) that appears hours after head injury, with subconjunctival bleeding that has no visible posterior limit, indicates fracture of the anterior cranial fossa (orbital roof or ethmoid) with blood tracking forward. A direct blow causes a bruise with a visible posterior edge of conjunctival haemorrhage.

Option by option

A. Two separate direct blows to both eyes
Direct blows cause local bruising and a visible posterior limit of conjunctival blood.
B. Fracture of the anterior cranial fossa with blood tracking into the orbits (correct)
Correct. Delayed bilateral black eyes with no posterior limit suggest an anterior fossa fracture.
C. A bleeding disorder causing spontaneous bruising
A bleeding disorder would cause bruising elsewhere, with history of bleeding.
D. Fracture of the mandibular condyle
A condylar fracture causes jaw swelling and malocclusion, not bilateral orbital bruising.

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 B, Fracture of the anterior cranial fossa with blood tracking into the orbits. Bilateral periorbital ecchymosis (raccoon eyes) that appears hours after head injury, with subconjunctival bleeding that has no visible posterior limit, indicates fracture of the anterior cranial fossa (orbital roof or ethmoid) with blood tracking forward.

Why is "Two separate direct blows to both eyes" not the answer?

Direct blows cause local bruising and a visible posterior limit of conjunctival blood.

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

A bleeding disorder would cause bruising elsewhere, with history of bleeding.

Why is "Fracture of the mandibular condyle" not the answer?

A condylar fracture causes jaw swelling and malocclusion, not bilateral orbital bruising.

What concept does this question test?

It tests Injuries: spectacle haematoma in Forensic Medicine. A direct blow causes a bruise with a visible posterior edge of conjunctival haemorrhage.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: spectacle haematoma?

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.