Trauma and burns: basal skull fracture: practice question

A General Surgery 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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General Surgery · Trauma and burns: basal skull fracture

Sample item

A man with a head injury has bilateral periorbital ecchymosis and clear fluid dripping from the nose. Which procedure should be avoided?

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

The answer and the reasoning

D. Blind insertion of a nasogastric tube

Raccoon eyes with cerebrospinal fluid rhinorrhoea suggest an anterior cranial fossa fracture. A nasal tube could pass through the fracture into the cranial cavity, so gastric tubes are placed orally. Orotracheal intubation and head elevation remain appropriate.

Option by option

  • A. Orotracheal intubation with manual in-line stabilisation

    Oral intubation with in-line stabilisation is the safe airway route in head injury.

  • B. Elevation of the head end by 30 degrees

    Head elevation helps to lower intracranial pressure.

  • C. Application of a cervical collar

    A cervical collar is used until the spine is cleared in any head injury.

  • D. Blind insertion of a nasogastric tube (correct)

    Correct. A nasal tube could enter the cranial cavity through the fracture.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Blind insertion of a nasogastric tube. Raccoon eyes with cerebrospinal fluid rhinorrhoea suggest an anterior cranial fossa fracture.

Why is "Orotracheal intubation with manual in-line stabilisation" not the answer?

Oral intubation with in-line stabilisation is the safe airway route in head injury.

Why is "Elevation of the head end by 30 degrees" not the answer?

Head elevation helps to lower intracranial pressure.

Why is "Application of a cervical collar" not the answer?

A cervical collar is used until the spine is cleared in any head injury.

What concept does this question test?

It tests Trauma and burns: basal skull fracture in General Surgery. A nasal tube could pass through the fracture into the cranial cavity, so gastric tubes are placed orally. Orotracheal intubation and head elevation remain appropriate.

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 Trauma and burns: basal skull fracture?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.