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Retired NBME Free 120 Answers

free120/Block 3/Question#4 (reveal difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerve ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bwdc(697)
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CNS amoebiasis is most notoriously caused by Naegleria fowleri, which I encourage you to memorize as the โ€œbrain-eating amoeba.โ€ Found in fresh-water bodies of water like ponds and lakes, it has three forms: a cyst, a trophozoite (ameboid), and a biflagellate (i.e. has two flagella). Infection is via olfactory cell axons through the cribriform plate to the brain.

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mullerplouis  To add to this it causes Meningoencephalitis. Look out for confusion and brain signs mixed with signs of meningitis. Only a handful of organisms that cause both. +7
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +44
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +13
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +2
melchior  In line with the thinking above, SketchyMicro teaches it as if it just passes through the cribriform plate, ignoring the nerves. Wikipedia says that it actually enters the nerves, then passes through the plate. +9
j44n  this is such an AWFUL disease, I worked in a hospital in south carolina where it happens A LOT and there's nothing at all you can do for them. When your cells go to phagocytose it it has an outer layer it sheds off like how a lizzard will sacrifice its tail when attacked by a predator. +3
07chess  j44n, I don't think that this happens A LOT. US has approximately 8 confirmed cases of N. Fowlery a year. The chances are we will never see this in our practice. But NBME thinks we should know it. +
msmith24  what is ironic is even the UWORLD box summary only has "through the cribriform place" listed as its description of entry +



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