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Retired NBME 15 Answers

nbme15/Block 3/Question#39 (reveal difficulty score)
A 42-year-old woman with multiple sclerosis ...
Medial longitudinal fasciculus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +2  upvote downvote
submitted by โˆ—cassdawg(1781)
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This is intranuclear opthalmoplegia, associated with damage to the medial longitudinal fasciculus (MLF). If you haven't really memorized this yet because you thought this was a minor thing (like me) you should because they really enjoy asking questions on it according to basically every practice test. (FA2020 p543)

How you know:

  • She has a conjugate gaze palsy of adduction but she can still converge (i.e. the medial rectus is not paralyzed because she can still cross here eyes)
  • It is more commonly seen in MS
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cassdawg  Because I weirdly always get this confused with superior colliculus: the superior colliculus directs eye movements to stimuli (noise, movements) or objects of interest +1



 -1  upvote downvote
submitted by โˆ—kaf(2)
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also interferon beta is clue she has MS.

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crappy  Question stem states this in the first sentence.. She has MS that's shot the MLF causing the gaze palsy. +



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