need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

Retired NBME 23 Answers

nbme23/Block 2/Question#43 (reveal difficulty score)
A 2-week-old girl is brought to the physician ...
Iris ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +39  upvote downvote
submitted by โˆ—hayayah(1212)
get full access to all contentpick a username

Coloboma is an eye abnormality that occurs before birth. They're missing pieces of tissue in structures that form the eye.

  • Colobomas affecting the iris, which result in a "keyhole" appearance of the pupil, generally do not lead to vision loss.

  • Colobomas involving the retina result in vision loss in specific parts of the visual field.

  • Large retinal colobomas or those affecting the optic nerve can cause low vision, which means vision loss that cannot be completely corrected with glasses or contact lenses.

get full access to all contentpick a username
mousie  thanks for this explanation! +1
macrohphage95  can any one explain to me why not lens ? +
krewfoo99  @macrophage95 Lens are an interal part of the refractive power of the eye. Without the lens the image would not be formed on the retina, thus leading to visual loss +5
qfever  Do anyone know why not choroid? +1
adong  @qfever, no choroid would also be more detrimental to vision since it supplies blood to the retina +3
irgunner  That random zanki card with colobomas associated with a failure of the choroid fissure to close messed me up +13
mnemonicsfordayz  Seems like the key to this question is in what is omitted from the question stem: there is no mention of vision loss. If we assume there is no vision loss, then we can eliminate things associated with visual acuity (weird to think of in 2 week old but whatever): C, D, E, F. Also, by @hayayah 's reasoning, we eliminate E & F. If you reconsider the "asymmetric left pupil" then the only likely answer between A & B is B, Iris because the iris' central opening forms the pupil. I mistakenly put A because I was thinking of the choroid fissure and I read the question incorrectly - but it's a poorly worded question IMO. +2
mamed  Key here is that it doesn't affect vision- the only thing would be the iris. All others are used in vision. Don't have to know what a coloboma actually is. +5
azibird  The extra section of that Zanki card specifically says that a coloboma "can be seen in the iris, retina, choroid, or optic disc." Don't you dare talk trash about Zanki! +3
fatboyslim  Honestly, I didn't understand what they were trying to ask...NBME has some weird wording sometimes +1
weirdmed51  you are a smart boy @mamed +
weirdmed51  @azibird ...upvoting @irgunner cos you went crazy there buddy๐Ÿ™ƒ +



 +8  upvote downvote
submitted by โˆ—chaosawaits(92)
get full access to all contentpick a username

Who else read that last sentence 100 times and still had no idea whether it was even English or not?

get full access to all contentpick a username



Must-See Comments from nbme23

ferrero on Precapillary resistance
yotsubato on 99%
sne on Triglyceride
sajaqua1 on Area labeled โ€˜Dโ€™ (Spinothalamic tract, right)
stinkysulfaeggs on Hypoglycemia
hayayah on Iris
soph on Peak inspiratory pressure (alveolar): ...
seagull on Area labeled โ€˜Cโ€™ (Cranial nerve 8: ...
water on Dietary change
wired-in on 28.8
beeip on Binding of permeable ligand to nuclear ...
thomasalterman on Hypoglycemia
yotsubato on Inhibition of the cytochrome P450-dependent ...
seagull on Decreased sodium bicarbonate reabsorption in ...

search for anything NEW!