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NBME 22 Answers

nbme22/Block 4/Question#39 (34.7 difficulty score)
A 5-year-old boy is brought to the physician ...
Retinal cells🔍

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hTe ihapyiscn adis eht byo is yllienku to odevlpe any eroht mslaopsen, so he sdeo'nt heav het ihreentid bR m.nottuai

nI hits ,asec eh sah eth asrpocid nmtlsbaoat.eoir oSpdrica rbsnootaaitlem riqruees otw oitasmc anuoisttm fo Rb in hte seam lerinat cell.

tsuJ sa a side toen: renidIteh enaomobtsisaltr nted ot eb .lraleibat pdcSaior aer u.laelanitr

carls14  aren't retinal cells a type of somatic cell? Why not is the mutation not considered in the somatic cell of the child? +8  
omerta  Although this mutation would be considered somatic, I believe the question is just asking you to be specific as to which cells. If you answered "somatic cells of the child," that's quite broad and could apply to almost anything. +11  
kernicterusthefrog  I had the same struggle and thought process. +1  
eacv  There is a Uworld qx that explain this in detail> ID: 863 +3  
arcanumm  I read the answer options too fast so got this wrong. It is a somatic cell type, but somatic in general implies a higher risk for developing other cancers. The hint here is that the physician stated he is unlikely to develop any other neoplasms, so it is a specific double hit mutation in the retina. +6  
almondbreeze  wouldn't she have any possibility of developing osteosarcoma as well? :( +  
almondbreeze  did some reading and it seems like osteosarcoma only occurs in familial retinoblastoma with RB mutation +