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Retired NBME 15 Answers

nbme15/Block 1/Question#47 (reveal difficulty score)
A 50-year-old man is brought to the physician ...
"D" label in the image ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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This is left homonomous hemianopia, which is caused by lesion to the contralateral optic tract (D). This occurs because the nasal retinal fibers (temporal visual field) cross at the optic chiasm while the temporal retinal fibers (nasal visual field) do not. See FA2020 p542 or here for image.

Lesion of the optic nerve (A or C) would cause complete blindness in either eye.

Lesion of the optic chiasm (B) causes bitemporal hemianopia.

Lesion to the left optic tract (E) would cause right homonomous hemianopia.

F and G are the oculomotor nerves.

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scoresloth  I made a very stupid mistake and forgot that the image is formed on the nasal side of the retina if the object is lateral to the eyes. +



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