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NBME 15 Answers

nbme15/Block 3/Question#39 (5.0 difficulty score)
A 42-year-old woman with multiple sclerosis ...
Medial longitudinal fasciculusπŸ”

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submitted by cassdawg(957),

This is intranuclear opthalmoplegia, associated with damage to the medial longitudinal fasciculus (MLF). If you haven't really memorized this yet because you thought this was a minor thing (like me) you should because they really enjoy asking questions on it according to basically every practice test. (FA2020 p543)

How you know:

  • She has a conjugate gaze palsy of adduction but she can still converge (i.e. the medial rectus is not paralyzed because she can still cross here eyes)
  • It is more commonly seen in MS
cassdawg  Because I weirdly always get this confused with superior colliculus: the superior colliculus directs eye movements to stimuli (noise, movements) or objects of interest +  

submitted by kaf(1),

also interferon beta is clue she has MS.