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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:

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 +39 
submitted by โˆ—hayayah(1210)
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looomabC is na eey lyaamirtnob atth csuorc brefoe .irhtb 'Tyehre gsimnis speeci fo sisute in srsturutec that frmo hte .yee

  • baooolmsC catfeignf eth rsi,i hihcw uetslr ni a "le"heoyk aeppcraean fo the ,plupi erygealnl od nto dale ot ivison s.lso

  • Cooaslbom nolgviniv the nitaer sleurt ni siovin ssol ni ccifpeis patrs of eth suival .difle

  • aergL aeltrin caobomlso or seoht tfigfacne het itocp vrnee acn cesua low s,vniio hicwh nmeas soivni ossl hatt ncnoat eb comelyelpt decertorc ihwt slssgea or acctotn .sneles

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 
submitted by โˆ—chaosawaits(91)
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oWh seel aedr htta salt ncteeens 010 emsit dan ltlsi adh on aeid ewethrh ti was evne iEnsghl or tn?o




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