NBME 20 Increased osteoclast maturation and activity (NBME Answers)

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Retired NBME 20 Answers

nbme20/Block 2/Question#7 (reveal difficulty score)
A 30-year-old man comes to the physician ...
Increased osteoclast maturation and activity 🔍 / 📺 / 🌳 / 📖
tags: endo PTH

+11 upvote downvote
submitted by cafeaulait(11)

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I veeielb siht tsem may be nregiinfr MNE 1 mnyoedrs - eobisspl mrotnisgaa i(cptep rcelu sieseda d,)x hadtriorayp ae,mnado nad tiarptiyu dmaanoe igusnac( DASI).H Bt,u yuo tdn'o dnee ot enev knwo hsti ot etg ihst ihgrt - stuj asgikn eth fcftee of gihh PTH no het etmsys - easusc cdsneeari asecttolso itvyitca sa llwe sa .nmtiuaoatr

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fatboyslim eTh mpsyostm of itsh nptaeit era edu ot hlaaeicrypcme tss(e,on s,obne on,rsga NOETHRS ecernais[d drs}sii,ue and hrspicycait ve.eoo)rnst raeliccpymHae anc aols aceus pipect ucelr ssiae.de So eht ripamry olhpgoyat is aoyirhratdp aaodanmpil/phsraeey csungai hte rhciaelaymecp +6

beetbox eosD naeyno oknw twhas' up iwth the 'no oamrbtseilani in musuher dyiXa'?Dr eyht sjtu wtrho ttah in ofr on ernao?s I otg hekodo no ,ti I ohhtgtu teher swa no nersdacie ltocsesoat iac.ytt..iv weeitrsoh teh orctcial seobn wlodu aevh enbe lydod nith or gomitnhes +4

topgunber MEN 1 - P P P . iPdrhaytr,oa ar(nisacanegtspr in iths ces,)a puaytitir eni.lso not yke to nesiwrgna sith . sqtiotupen ceosm thwi ymstopsm of ,aceaecprhimyl nam,so og,srna tosrnhe eg,p()ine yspch noLvoeteo sr.ko ta thp adn uccmali. ew see hihg ca nda hhgi .hpt We nowk htat ghih mcciual owlud oelwr t.ps.hht.i snmae eht ghih camicul wsa eud ot the gihh htp .e(i. airtrdpahyo eeQ mao)nontudais si ulalctya giaskn: twah ear teh fcftsee fo HPT? ,a ,c piptoeos of TDH P nad E i lveibeed an'ert dlteear ot Tn-HosuBdPS etgnomshi ilek eht peeahsonsigt of rpero-pdaseyuahsdtioFmihy p we deilyfenti knwo ttha TPH naseersci Ca , so yb iasnencirg eatsoosltc vuiti/ayitatamtcorn ouy etirelab ulaicmc tion het o.bdlo siht is het bste nrweas. +3

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submitted by ∗laminin(18)

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acn smeneoo elnxipa hyw it yass eh ahs an c'tait'n THP tr.eotcn.niocan.si ti to etl us konw ttah teh THP cnetnacoinrto is a selrut of t?l goaapyndoh s'awht shi ?xd ks!tnah

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yotsubato I weras yhet mkea pu oesm fo thsi ftfu.s Lkie washt up hitw hte ,tirhts r,niauinot nda tcppie ecurl seeia.ssd +9

redvelvet ralpymeccahei nac eacus coepnnihgre aeebitds iisdnpu;s os tsti,hr rn.oinutai erpaecmlcyhia nac sola sauec tpiecp lcure ee.assid iHs mmtyspos rae lla butoa aerplihayccem ude ot daros.piampyhrrtihye +4

namira yeHclpamceira" acn cseau anlre ifntuscdyon uhsc as corphngenie sibdteae diiissnup ,N)(DI ubt eht msihemnsca idgrlnuyne ryuhieimcae-lcpdcdnae IND ear nto lwel tds"oer.oudn t0/uwfrl/e-1)8.il(nte3/2wl6:r-4r95aoei0h/i/.nxlt3kSy0d807wtagt5ops-intentca +2

dulxy071 yWh 'cant teh eoccrtr rswena be )C ichwh sonipt drwsato anrel auif,ler hwich may dlea to oeadscrny iriyremhypdoptahsar vgihna the msae lstreus I velebei +2

pmofmalasia hTe ncodearsy hrpirasioaeyrthmdpy in nrlae euifarl si due ot sosl of ulimcca ni teh iugtnoonnfnic-n nye.kdi In shti nsquetoi eht iacucml aws deee,latv os uoy nac rlue otu areln lira.ufe +1

sars aHrilymepa-cce easusc nsoset au(imlcc eso)nst, ngoasr i)tnsinpooa,ct( thesonr esi(arnecd io,natr)inu nsboe asrcedei(n stalotsoec n),tioicavta nda circipstyah envteorso (o.epiedr)sns +1

epiglotitties uyo@aottbs osal sa emoeons itennemod ni otnraeh ,metcmon i hknti hr'teey ithginn ttha the xp hmtig vhea E.NM1 iordPtayahr le-yrpahspia a,yracchleiemp yatiruitp -mdaanoe HSADI rotsrin+itu,ta()hin and crctiepaan mtuor- aroginasmt i(pecpt ulcer e)aiseds +

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+2 upvote downvote
submitted by killme(14)

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Teh onccept igebn edetst is tah"w edso THP do tath lased to ccepl mayriah"ebnVh.emPtag/sKij3bp:it/sc.dpo/.gi/

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yotsubato g,uh ubtlsh.li I aws nyirgt ot egurfi otu an uclaat esadesi sseporc eer.h +7

rio19111 sti mriypar yrapdterimhsohyrpai decusa yb riydtarahpo oaen.adm idtaiond fo het tepipc elcru sstuegg glZielnor g-t&-;- 1EMN utb enon of taht si mpi cueabse hats't not hatw tyeh are k.nsiag llA ehty aer gnksai fro is the cnifnuto fo HP.T +3

topgunber MNE 1 - P P P . iahyrtdrPo,a esaianstp(grcran in ihts c)a,se tpuatiriy oel.sin tno yek to ignnreaws ihst ep.t siunqot mocse itwh tmpomsys of rpilmcyaa,ehce nm,osa an,rsgo nohtres (),egnpei pychs vren.Lteokoos o ta thp dan .iamclcu ew see hhig ac nda ighh thp. We kown hatt high amccliu wluod wreol hpi..sht.t smnae het hghi muiccal wsa due to het ihhg pht .i.e( rayatiprohd mntoeaQ)siden oau si tlluaacy :ksniga what ear hte eecfsft fo TPH? a, c, ppetoosi of PD TH adn E i ldvibeee 'trane rtdelae to sBou-HTdSnP miheonstg ekli teh seeogashnpti fo -meuhshtippa piyordrysFeoad ew efediytlin onwk hatt THP sresneiac Ca , so by ecnnrgaiis alocttseos ro/itaniatvautctmiy uyo ebaltire mcialcu ntoi teh dlobo. itsh si hte tesb wa.rsen +1

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+2 upvote downvote
submitted by ∗sympathetikey(1600)

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nI oaddinti to PHT = cstsolaeot ctiytiav = daniescre cu,malci ihst nesrop lcoud aols be iebgtixinh mtyopmss fo ME1.N

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topgunber NME 1 - P P P . yhPr,airtaod einatagsrarcnsp( ni hist ac,s)e uiriyttap snoiel. not key to iaswnnerg tsih to.qspeit un soemc hwit possmymt of paeccailerhym, so,amn ano,rsg tsnheor eni,pe)(g shypc otoenorkevs.o L at htp dan al.cicum ew ese ihgh ac adn gihh h.tp We wokn taht hhgi lccuaim odlwu ewrlo spi.htt..h aesnm het gihh lmciuca asw ude to hte ihhg hpt ie.(. ahrtiaodypr t inouae)anmdQeso is atllaucy ksai:ng thaw ear eth cftfsee of TH?P a, c, tsopeiop fo HDT P dna E i dvibelee etnra' alreedt ot T dns-SBuHPo ieomnshtg ikel the enoepatihgss of sdeaoFodeiihymhptaupr y-prs ew ydeltfinie nwok taht HTP iesecnsra Ca , os yb rcgeinnsia oscaltoste aruitvoynima/ttatic uoy rbeleita iuccalm iotn teh bdolo. itsh si eht setb ewsran. +1

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+1 upvote downvote
submitted by rio19111(16)

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sti rapmryi paeyaydoihmrrshptir asuced yb rryatahopid oaen.dam dioiatdn fo het tpecip elurc tsgseug eiZgnolrl g;-&--t 1EMN

utb neon fo htta si imp saubeec sah'tt ton tawh hety aer sk.agni lAl hyte aer asgkni rfo is the inucftno fo .PTH

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rio19111 eSns,ot ao,ngrs enrsh,ot hptiycasric oveostrne g;--t&- ssommypt +1

topgunber MNE 1 - P P P . Prrihd,taoay aerti(aspncansgr in htsi s),cae ittpriyau i.enlso ton yke ot sninegarw tish uepqoit .nts seocm wthi mytmosps of aeey,mplhricca monas, snga,or seotrhn ie(e,)npg yhpsc sv .eoeroooktnL ta tph and c.cilamu ew ese hhig ac nda ihgh .hpt eW okwn htat ghhi ulcacmi dluwo lrowe .i.tsht.hp enmsa teh high iulccma swa eud ot eht hghi pth (..ie ryhtoaridap dQsoueeam)ontn ia si ltacluya akgin:s waht era eth sceetff fo T?HP a, ,c ispetpoo of H TDP nad E i bdelveie nr'tea lrdatee to dnTSsBuP-Ho gsnitmoeh ekil the onetisgphaes fo tepyo usmrpdhseip-Frdyiohaa ew telnefdiiy nkow hatt PTH rsenciesa aC , os by seangicirn loctstaoes viomaa/iiuatcytrntt uoy beiltera ialucmc tnoi eth doblo. htsi si eth stbe nsreaw. +1

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submitted by ∗nwinkelmann(366)

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esDo neyona owkn het cisicnaginef fo oynecmto iiomy?ttl

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submitted by arthur_albuquerque(1)

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ahtW dlhepe em ot wsrean hits eon iqtue sayeil was eht oflgoilnw erotnliaa:

eamrcyHaeicpl + gihh HPT -&t;g yrmrap"i ahrameryh"ysidtorppi

Hwo do ghih PHT edal ot pearlyaeichm?c ncsageiIrn tsoasletoc y!tivatic

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submitted by ∗topgunber(68)

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MEN 1 - P P P . aoydPa,rhrti setapg(csnnariar ni tihs ),case tartyiupi io.enls not yke to nirenagws hist siqtu.oen

pt mosec ithw msostmpy of elaah,ycciepmr ,omsan rango,s nrothse ie(,pge)n shcpy tsoner.oev

okoL ta thp nad cmci.lau we see ihgh ac nad ighh t.hp We nowk atth hgih miacucl oldwu rwleo ..shitht.p snmae het ighh amilccu asw edu to teh hhig tph ie.(. iaahtorrdpy an)oedam

usoeQint si uacatlly gs:knai wath are teh sefectf fo HPT? a, c, ptipooes of THP

D and E i leedvebi etnra' adrelte ot THP

uod-sBSn sgnoetimh like the spgeeanosiht of ayihapmdpsseroproueydtih

F- we itfdieeynl wnok ahtt HTP sairneecs Ca , so yb scieiagnrn tlcsoetaso tiiutamvac/oryiatnt oyu tiareelb acmclui ntoi teh o.ldob htsi is teh sebt s.enrwa

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