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Retired NBME 15 Answers

nbme15/Block 1/Question#38 (reveal difficulty score)
A 23-year-old woman comes to the physician ...
Oculomotor nerve ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by ploy901(13)
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The oculomotor nerve innervates every ocular muscle except for lateral rectus and superior oblique muscle, so a lesion to this nerve will present with a down and out eye. It also controls constriction of the iris, so a lesion to the nerve will present with an abnormally dilated pupil. In this question, it's described as the patient having a history of visual discomfort in bright lights.

a lesion to the abducens presents with a medially deviated eye

a lesion to the MLF presents with internuclear ophthalmoplegia, which would be an eye that doesn't ab/adduct past the midline, but will do so on accommodation testing. looks like this

it's not the superior cervical ganglion because that while that also presents with ptosis, you should have miosis, as well as anhidrosis

a lesion to the trochlear nerve presents as a bad eye rides high lesion

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