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Retired NBME 20 Answers

nbme20/Block 4/Question#4 (reveal difficulty score)
A 20-year-old man comes to the physician ...
Olfactory ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +8  upvote downvote
submitted by โˆ—hayayah(1212)
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A fractured cribriform plate (anterior skull trauma) can result in leaking of cerebrospinal fluid into the nose and loss of sense of smell. Smell plays a large role in the perception of taste. So, in practice, a patient may complain of loss of taste rather than of smell.

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brownielove79  can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!! +2
doodimoodi  Olfaction is actually more important that tongue sensation in terms of food taste (think of how food tastes bland when you have a cold) +2
doodimoodi  than* +
champagnesupernova3  If taste is completely lost then it's an olfactory issue. If its lost only on a part of the tongue then the nerve that provides taste to that area is suspected. +14
veryhungrycaterpillar  UWorld QID 12227 The sense of taste isn't lost due to CSF in the nose, but due to avulsion of olfactory rootlets. +13
topgunber  yeah i wanted something to do with chorda tympani but i guess its something to remember +



 +3  upvote downvote
submitted by โˆ—dickass(127)
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It can't be the Facial nerve, physical examination was normal. Someone would probably notice the face symptoms.

I went with Glossopharyngeal, but that wasn't it.

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garima  I thought the same for olfactory, he would have realize he can't smell... :O +4



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