Test Your Knowledge of Closed Head Injuries (Postscript 3 of 4)

EBUC Postscripts
Management of Closed Head Injuries in Urgent Care | May 2022

A 72-year-old man who is an out-of-state resident is brought to the urgent care clinic by his daughter for a complaint of a scalp laceration. An hour prior to presentation, he was carrying a shovel and rake through his daughter’s yard and back to the garage when he tripped and struck his forehead on a ground-level outdoor light fixture. He denies loss of consciousness or significant headache, and he has normal vital signs and a normal neurologic examination. There is a 3-cm, oozing laceration in the left frontal region with some surrounding ecchymosis/hematoma. The patient’s tetanus status is confirmed to be current, but he hurried to the clinic and does not have his medication list with him.

Which of the following medical conditions would make you suspicious that this patient is taking medication that is high-risk in the setting of head trauma?

A. Rheumatoid arthritis, for which he takes an unknown monthly injection

B. Diabetes mellitus, with insulin having been recently added to oral medication

C. Hypercholesterolemia, for which he takes a daily oral medication

D. History of a “heart stent” last year

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Last Updated on January 26, 2023

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