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  1. #1
    vinny is offline Junior Member
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    Question on the NBME test 1

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    A 4-year-old boy has had constipation and painful defection since birth. Impacted fecal matter is palpable in the lower abdomen. Examination of tissue obtained on biopsy of the rectum shows absence of cells of the myenteric plexus. The most likely cause is a defect in which of the following developmental events?
    A) Alar plate maturation
    B) Anterior neuropore closure
    C) Neural crest migration
    D) Paravetebral ganglion formation
    E) Posterior neuropore closure
    F) Recanalization of the bowel

  2. #2
    AriVederci is offline Junior Member 510 points
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    Hirshprungs Disease

    C - Neural Crest Migration

  3. #3
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    PRS
    PRS is offline Newbie 510 points
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    i agree with arivedreci, ans is C

  4. #4
    sky_forest_sea is offline Newbie 510 points
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    Me Too

    I Also Agree.

  5. #5
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    dchaos_g is offline Junior Member 510 points
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    Definitively, the answer is "C" - failure of Neural Crest Migration.

    Quote Originally Posted by emedicine.com
    The congenital absence of ganglion cells in the distal alimentary tract is the pathologic sine qua non of HD. The aganglionosis present in HD results from a failure of cells derived from the neural crest to populate the embryonic colon during development. This failure results from a fundamental defect in the microenvironment of the bowel wall that prevents ingrowth of neuroblasts

  6. #6
    sarda is offline Member 510 points
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    Ccccccccccccccccccccc

  7. #7
    pinkee is offline Newbie 510 points
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    Ccc Is The Right Answer

  8. #8
    elle is offline Newbie 510 points
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    I am going with the majority, its Neurocrest ;Hirschsprungs agangliosis. feculent vomit, distention with obstipation males>>>>females 0-2yrs. the give away is the abscence of the nerve cells.!!!!!in the Q.

  9. #9
    st_55 is offline Member 510 points
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    it is definitely c

  10. #10
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    followup question:
    What abnormality you can see if there is a is failure to close the Posterior neuropore closure?
    2- and what about the anterior one?
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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