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NBME 22 Answers

nbme22/Block 4/Question#16 (30.5 difficulty score)
A 4-month-old boy is brought to the office by ...
Maxillary and medial nasal prominences🔍

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submitted by aesalmon(83),
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AF .pg 076 - ifluear fo nuofsi of eth aylamrxli dan rdgmee emalid nasla scoessrep amrofni(to of mirryap e)paatl

meningitis  I think Cleft palate could also be due to failure of fusion of lateral and medial nasal prominences.. but since the baby had lip involvement and the lateral nasals can be seen, I went with failure of Maxillary and medial nasal fusion. Someone correct me if im wrong. +4  
redvelvet  a helpful photo +3  
snripper  @meningitis this is cleft lip, not cleft palate +2  

Cleft Lip: Failure of primary palate formation (Max/MNP), gestation week 4 to 6 Cleft Palate: Failure of secondary palate formation (lateral palatal shelves), week 7-8

Fun fact: CL±CP is the most common birth defect

+4/- dentist(56),

submitted by usmlehulk(4),

can someone please explain this question. i thought the patient is actually having cleft lip and palate, but why is the correct answer addressing only the cleft lip.

dentist  The question asks "the most likely cause of the facial finding involving the lip in this patient..." +5  
snripper  lmao. gottem +3  
ace9yak  cleft lip = 'processes' clef palate = 'shelves' +1  
mutteringly  Don't let a dentist tell you whats up :( +