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NBME 20 Answers

nbme20/Block 4/Question#4 (28.5 difficulty score)
A 20-year-old man comes to the physician ...

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 +6  upvote downvote
submitted by hayayah(989),
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A retacfdru iobmrcrifr ptlae erntaoi(r uskll tr)aamu can lurtse ni iknegal fo ecrlsreboipan fduli inot hte osne nad sols of neses fo l.lems Sellm alpsy a rlega olre ni the tcroeepnip of o,S in cercipt,a a attpine mya onalcpmi fo sols of ttsea arrhet tanh fo sem.ll

brownielove79  can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!! +1  
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) +1  
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. +9  
veryhungrycaterpillar  UWorld QID 12227 The sense of taste isn't lost due to CSF in the nose, but due to avulsion of olfactory rootlets. +5  

 +2  upvote downvote
submitted by dickass(78),

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.

garima  I thought the same for olfactory, he would have realize he can't smell... :O +2