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Retired NBME 22 Answers

nbme22/Block 4/Question#16 (reveal difficulty score)
A 4-month-old boy is brought to the office by ...
Maxillary and medial nasal prominences ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—aesalmon(95)
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FA pg. 607 - failure of fusion of the maxillary and merged medial nasal processes (formation of primary palate)

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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
snripper  @meningitis this is cleft lip, not cleft palate +2
chaosawaits  @snripper, it's both. If you're palate looks like that, that's not normal fyi. The reason the answer is maxillary & median nasal prominences is because the question tells you to focus on the lip aspect of the patient's presentation. +
claves  FA 2020 621 +
claves  FA 2020 621 +

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: CLยฑCP is the most common birth defect

+6/- dentist(94)

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submitted by usmlehulk(7)
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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.

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dentist  The question asks "the most likely cause of the facial finding involving the lip in this patient..." +8
snripper  lmao. gottem +4
ace9yak  cleft lip = 'processes' clef palate = 'shelves' +2
mutteringly  Don't let a dentist tell you whats up :( +1


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