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NBME 20 Answers

nbme20/Block 4/Question#4

A 20-year-old man comes to the physician stating ...


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 +4  upvote downvote
submitted by hayayah(505),

A fractured cribriform plate (anterior skull trauma) can result in leaking of cerebrospinal fluid into the nose and loss of sense of smell. Smell plays a large role in the perception of taste. So, in practice, a patient may complain of loss of taste rather than of smell.

brownielove79  can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!! +  
doodimoodi  Olfaction is actually more important that tongue sensation in terms of food taste (think of how food tastes bland when you have a cold) +  
doodimoodi  than* +  
champagnesupernova3  If taste is completely lost then it's an olfactory issue. If its lost only on a part of the tongue then the nerve that provides taste to that area is suspected. +3  

 +1  upvote downvote
submitted by dickass(22),

It can't be the Facial nerve, physical examination was normal. Someone would probably notice the face symptoms.

I went with Glossopharyngeal, but that wasn't it.

garima  I thought the same for olfactory, he would have realize he can't smell... :O +1