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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 πŸ” / πŸ“Ί / 🌳
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 +47 
submitted by βˆ—mousie(259),
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Why nto liruleoaht amcirca?no Or ohw did you rule ti u?to I wsa nigihntk dtianraoi oluwd ercisane kirs rfo fuertu ...CA


 +38 
submitted by βˆ—hayayah(1169),
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oooamClb is na eye ytiloamabnr ttha csuocr eefobr hbt.ir 'Teryeh ignsmsi icesep of utsesi in tcusrtures atth rfom the eye.

  • Cooomalsb tfgefainc het i,rsi whcih uslter in a oley"hk"e apnarpcaee of het ippl,u elgnealyr do ont dlea ot ivison ossl.

  • maloobCso oivingvnl eth nareit eurlts ni siivno ossl ni pficesci tapsr of the uavsil fdiel.

  • egraL tlianre sacomolbo or otesh cntffgiea het opict vrene nca aucse lwo viino,s hiwhc smean ivnios olss htta ncnato be loleytcemp crteecrdo with lasegss ro ontactc se.snle

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 +12  
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  
testready  https://aapos.org/glossary/coloboma +1  
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 buddyπŸ™ƒ +  



 +3 
submitted by βˆ—chaosawaits(63),
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Who seel eadr that ltas ctnneese 001 eimst dan slitl hda no edia wtrhehe ti asw enev snlihgE ro ?tno




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