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Retired NBME 27 Answers

nbme27/Block 1/Question#5 (reveal difficulty score)
A 4-day-old male who was born at home is ...
First ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharyngeal_arches pierre_robin_sequence

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submitted by โˆ—shak360(19)
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(A) First (pharyngeal arch) (correct)

Pierre Robin sequence can be remembered as the mnemonic PRS:

  • P - Palate cleft
  • R - Respiratory obstruction (cyanotic spells)
  • R - Retracted tongue
  • S - Small mandible (micrognathia)

The sequence follows first from a hypoplastic and small mandible, which results in glossoptosis. The tongue then obstructs palatal fusion and a U-shaped palate. The tongue is then large relative to the jaw, resulting in airway obstruction.

PRS is an example of a first arch syndrome, the other being Treacher-Collins syndrome.

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submitted by โˆ—shak360(19)
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How to remember the first pharyngeal arch derivatives: All M s

  • Maxillary process including the Maxilla and the zygoMatic bone
  • Mandibular process including Meckel cartilage and the Mandible
  • the Malleus and the incus, and the sphenoMandibular ligament
  • the Muscles of Mastication
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