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NBME 24 Answers

nbme24/Block 2/Question#40 (42.0 difficulty score)
A 4-year-old boy has a 1-cm round midline ...

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submitted by dbg(140),
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mA I eth nyol neo woh tughto,h ym oewhl fli,e taht ti auatclly gsteaiorin omfr het irodhyt tbu ustj yiclasylhp ncdoecnte ot eht negtuo

nbmehelp  same +14  
medguru2295  me! I went with submandibular gland bc I thought there was a gland under there. +  
alexxxx30  nope...i definitely thought the same thing...when I clicked thyroid I was like wow that was an easy question. HA +  

submitted by famylife(86),
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ogaysT"olshlr udtc csyst mtos noetf neeprts twhi a pabllepa ttociymaasmp nelmidi eckn ssma ayuulls bloew %[56 of teh ime]t eht elelv of hte ioyhd e.b"no

The" ossatllyhorg atctr saisre romf eht nfreamo cmuec ta the jucniotn of eht raiotren trhw-doits adn isrptrooe hnr-iedto of eth eou.t"ng


dbg  Am I the only one who thought, my whole life, that it actually originates from the thyroid but just physically connected to the tongue +15  

go watch the osmosis video of thyroglossal duct cyst and you will never get any qs wrong , i learn my lesson , same question for 3 nbmes i got wrong

+7/- usmlecrasherss(13),

^ : osmosis thyroglossal duct cyst

+4/- drdoom(805),

submitted by haozhier(15),

Can someone please explain to me: If the posterior 1/3 of the tongue is developed from 3rd and 4th pharyngeal arches, why is it wrong to choose pharyngeal arch?

therealslimshady  Welcome to NBME +2  
mutteringly  First time? (meme) +1  
drdoom  That would be like choosing “blastula” if it were an option: it's not wrong but there's a more precise answer. +  
pontiacfever  That is wrong. They're indicating towards thyroglossal duct/thyroid which originates from Pharyngeal pouch not arch. secondly, they're asking that the mass originated from which structure. So, as we know it is associated to foramen cecum which is related to tongue. +  
drdoom  @pontiacfever, i believe you’re responding to @haozhier’s original comment, yes? +  
pontiacfever  @drdoom, yes the original comment by @haozhier +1  

submitted by apurva(68),

Pharyngeal arch is not same as pharyngeal floor, pharyngeal arch is mesoderm from which nerve artery muscle cartilage develop. Pharyngeal floor is from where tongue develops which is endoderm

mutteringly  However... 4th-6th pharyngeal arches do develop ACCCT (arytenoids, cricoid, corniculate, cuneiform, and THYROID). Thyroglossal duct cyst: a remnant of the thyroglossal duct that forms during the embryonic development of the thyroid gland. The thyroid gland originates from the foramen cecum at the base of the tongue and descends caudally into the neck, creating the thyroglossal duct. If the duct fails to obliterate, midline neck cysts or ectopic thyroid tissue can develop anywhere along the path of the thyroglossal duct. +