NBME 21 1,25-Dihydroxycholecalciferol (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

search for anything ⋅ score predictor (“predict me!”)

Retired NBME 21 Answers

nbme21/Block 3/Question#6 (reveal difficulty score)
A 40-year-old African American woman comes to ...
1,25-Dihydroxycholecalciferol 🔍 / 📺 / 🌳 / 📖
tags:

+13 upvote downvote
submitted by ∗nosancuck(102)

get full access to all content ⋅ pick a username

This b has Sarcoidosis so her granulomas be activatin dat VitD

get full access to all content ⋅ pick a username

sbryant6 Your mom activates my VitD. +23

pg32 Anyone know why there is hepatosplenomegaly? +

gooooose Likely granulomas involving the liver and spleen- Pathoma says any organ can be involved +

fatboyslim Don't call her a b, b. +

+11 upvote downvote
submitted by ∗medpsychosis(147)

get full access to all content ⋅ pick a username

This patient definitely has Sarcoidosis. Clues in question stem: -African American Female -Erythema Nodosum -Bilateral Hilar Adenopathy -Hypercalcemia (due to 1α-hydroxylase–mediated vitamin D activation in macrophages).

FA 2018 (P. 658)

get full access to all content ⋅ pick a username

icedcoffeeislyfe FA2020 pg 676 +

lovebug and FA2019 pg 662: Vit.D usually activated in Kidney. but They can be also activated by Macrphage like this case. +

+3 upvote downvote
submitted by ∗dr.xx(176)

get full access to all content ⋅ pick a username

~~In sarcoidosis,~~ hypercalcemia normally suppresses the release of PTH and therefore the production of calcitriol (1,25-dihydroxycholecalciferol), but in sarcoidosis and other granulomatous diseases, activated mononuclear cells (particularly macrophages) in the lung and lymph nodes produce calcitriol (1,25-dihydroxycholecalciferol) from calcidiol (25-hydroxycholecalciferol) independent of PTH.

https://www.uptodate.com/contents/hypercalcemia-in-granulomatous-diseases

get full access to all content ⋅ pick a username

dr.xx ~~In sarcoidosis,~~ +

hello Probably a typo in the first 2 words of the explanation -- not sure what they meant to say instead +

drdoom I believe @dr.xx meant to strikeout "In sarcoidosis" from his comment; double-tilde is the markdown plaintext that usually accomplishes that. +

Must-See Comments from nbme21

nosancuck on Absorption atelectasis
assoplasty on Free T4
seagull on GM2
lnsetick on Apocrine
niboonsh on NMDA receptors are blocked by Mg2+ at the ...
drdoom on Deletion of a hydrophobic amino acid ...
hayayah on HCO3− transported in the plasma
mcl on Aortic
notadoctor on Usual interstitial pneumonitis
madojo on Genital herpes
hungrybox on Obstruction of the bile duct
jambo2222 on Lung
hungrybox on Mismatch repair
hungrybox on Hydrochlorothiazide