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NBME 16 Answers

nbme16/Block 4/Question#35 (13.1 difficulty score)
A 51-year-old woman comes to the physician ...
Area labeled by the letter 'B'🔍

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Good explanation on reddit:

Essentially, A = mucinous glands (foamy cytoplasm) B = parietal cells (stain eosinophilc, P ar I etal cells stain PInk w/ a fried egg appearance. Additionally, they're above chief cells C = chief cells (stain basophilic, super dark, and below parietal cells)

md_caffeiner  reddit: Its not about histology knowledge, you just need to know two things about parietal cells - they are eosinophilic on histo and they are located more superficially compared to chief cells (super basophilic, labeled as C). If you know chief cells are C, mucinous glands are A due to the foamy cytoplasm, the answer has to be B. +  
md_caffeiner  reddit2#You're exactly right (although I would say it is histology knowledge). Gastrin stimulates both parietal and chief cells but only parietal cells release hydrogen ions (and chloride ions - to make HCl). ArtiomK is right about the staining and location of parietal cells being highly acidophilic (pink) and predominantly at the apical part of the gastric gland - they're often described as having a fried egg type of appearance (big, round cytoplasm [egg white] with a central, round [yolk] nucleus). Chief cells produce pepsinogen (enzyme) so display the basal basophilic (purple) staining and they're found predominantly at the base of the gastric gland. So, it's a mix of theory and practical understanding - knowing the structure and function of the gastric gland and then the practical histology of the gland (and its cellular composition). +  
md_caffeiner  dont go to reddit and get distracted for 15 minutes lol +3  
deberawr  it's better than redownloading tiktok and getting distracted for 3 hours lol (don't do what i did its embarrassing) +  

first should know that this is the fundus or body of the gastric, so it should be the parietal cell domaine; then think the mucus is the protective one , A without hesitate. then the other on the upper glandular layer should be the paretal cell, which is B. others like C is so small ,in the deeper glandular layer and basalphilic looking maybe is the chief cell . then deeper could be the submucosa layer. UW ID124 fyi.

zme331  ???? +  

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