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NBME 23 Answers

nbme23/Block 1/Question#4 (33.3 difficulty score)
A male newborn has a myelomeningocele that ...
Closure of the caudal neuroporeπŸ”
tags: neurology embryology FA19p479 

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submitted by sweetmed(138),
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submitted by mousie(211),
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mousie  Caudal = Bottom of the SC = failure to close = spina bifida and Rostral = top of SC = failure to close = Anencephaly +10  
powerhouseofthecell  I'm confused. In first Aid doesn't have meningomyelocele as failure of caudal or rostral pore to close. Is the answer Cadual because in this patient specifically, his condition takes place on L2-5 which is more caudally? +2  
usmile1  its a neural tube defect aka failure of neural tube closure +  

submitted by almondbreeze(82),

FA2019 pg.479 + spina bifida occulta: failure of cudal neuropore to close, but no herniation + anencephaly: failure of rostral peuropore to close --> no forebrain, open calvarium

submitted by avocadotoast(13),

This child has spina bifida. Failure to close the neural tube can lead bladder and bowel dysfunction in the fetus --> oligohydramnios --> compression of the fetus, clubfeet, etc. Axis specification and zone of polarizing activity is implying a defect in the sonic hedgehog gene that would lead to holoprosencephaly Closure of the rostral neuropore would cause anencephaly. Defective development of the apical ectodermal ridge would cause distal limb malformations. Without the neuropore, the neural plate and nervous system wouldnt form. Defect in scheduled apoptosis can present with webbed fingers, etc.