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NBME 23 Answers

nbme23/Block 2/Question#43 (reveal difficulty score)
A 2-week-old girl is brought to the physician ...
Iris πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—mousie(252),
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Wyh nto uroaelhtli cacno?miar Or owh ddi ouy elru ti t?ou I aws gitnkinh atioardin oudwl scneriae irsk rfo retuuf ...CA

submitted by βˆ—hayayah(1147),
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aooomlbC si an eye aobrltnyiam taht cuscro ebfore thir.b rThe'ye igmniss sciepe fo tisesu in rreutsctus atht rmof eht

  • soCbmooal ingacteff the irs,i which tserlu in a koe"ly"he naeaprpaec fo het ,pliup erlenalgy do tno ldae ot iovsni ss.ol

  • ooClsamob glvvoiinn eth atreni urslet ni vniois slos ni icceifps sptra fo the iulvas eil.df

  • agerL rianetl acomsolob ro shote atefngcif the oitcp evnre cna esuca wlo nsvii,o ihhwc anesm vsonii loss htat anntoc be tmceepolyl eerdrtcoc thiw selssga ro otctacn sne.les

mousie  thanks for this explanation! +1  
macrohphage95  can any one explain to me why not lens ? +  
krewfoo99  @macrophage95 Lens are an interal part of the refractive power of the eye. Without the lens the image would not be formed on the retina, thus leading to visual loss +4  
qfever  Do anyone know why not choroid? +1  
adong  @qfever, no choroid would also be more detrimental to vision since it supplies blood to the retina +3  
irgunner  That random zanki card with colobomas associated with a failure of the choroid fissure to close messed me up +12  
mnemonicsfordayz  Seems like the key to this question is in what is omitted from the question stem: there is no mention of vision loss. If we assume there is no vision loss, then we can eliminate things associated with visual acuity (weird to think of in 2 week old but whatever): C, D, E, F. Also, by @hayayah 's reasoning, we eliminate E & F. If you reconsider the "asymmetric left pupil" then the only likely answer between A & B is B, Iris because the iris' central opening forms the pupil. I mistakenly put A because I was thinking of the choroid fissure and I read the question incorrectly - but it's a poorly worded question IMO. +2  
mamed  Key here is that it doesn't affect vision- the only thing would be the iris. All others are used in vision. Don't have to know what a coloboma actually is. +5  
azibird  The extra section of that Zanki card specifically says that a coloboma "can be seen in the iris, retina, choroid, or optic disc." Don't you dare talk trash about Zanki! +3  
testready +1  
fatboyslim  Honestly, I didn't understand what they were trying to ask...NBME has some weird wording sometimes +1  
weirdmed51  you are a smart boy @mamed +  
weirdmed51  @azibird ...upvoting @irgunner cos you went crazy there buddyπŸ™ƒ +  

submitted by βˆ—chaosawaits(44),
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oWh eles raed ttha aslt ecntenes 001 ietms and lstli ahd on aied etherwh it aws neev nhgilsE or on?t

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