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Retired NBME 21 Answers

nbme21/Block 4/Question#31 (reveal difficulty score)
A 48-year-old woman comes to the physician ...
Paracrine stimulation of osteoclasts by osteoblasts ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—tinydoc(276)
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rarsdrHmteiphpyoyia sugcian oben nsisole is aiv blOsosttsea ngnersciia RAKN L- pneirosexs ot ndbi ot KANR no totesOlssca nda tnlgismiuta ehtm g-t&;-- nci noeB oReprionst

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pg32  kecidP D epseidt turasnennddgi het avbeo ^^ cbeesua 1IL- si olsa onwnk sa osoalttsec itavtianicg a.ro.t.cf +8
plzhelp123  ^ I ddi hte mea,s btu it spparae ahtt 1LI- tavicetsa stelotscsao in lieltmpu mlea.oym cWhih mkaes snsee sa that is a lopsname of emnmiu lelsc wihhc can epdrcou ieluktesr.nni +
caitlyncloy  can noeany xanpiel hwy sthi eth warens is NPR"EC"RIAA nois??mtatliu I urel uot hte roetrcc newrsa sucebae i asw picurting RANK nad ANRK L dngibn,i chwih si not !?erprniaac +1
caitlyncloy  o.h. ti esme ARKN L si deecsetr ot ivtaetca het at.l.ssc i wsa cipgrtniu it sa RKLNA saw on teh cueafrs fo hte .labts :ecrere fen thusvJ/wtb/:?emuwtoB=Ohp/aoehRIywA.sec.tctw +1
makingstrides  If uyo nc,a I ulWdo liyhgh domrneecm oliongk ta eth tescykh aprhm rof .sthi It snexplia hist w,lel ni my ,oniponi nad ydfitienel pldehe em. +
jatsyuk38  onljGa I vu'doecl snwor asid HPT uiltsatmse btsstseaolo to rectese LI-1 ot cvittaae oost.scsetla eH osal idas teerngos retevsnp poissotresoo yb nniibtihgi ssbloeotat ealseer fo erv.wo.h-1IL.e rheet si osal a lWUdro uiqotsne rwehe ti adis L-ANKR pasly a erom tiaormntp erol arcto vr(oe 1L-I) in HPT meadtedi oebn rdakeownb +1

Primary hyperparathyroidism: overproduction of PTH by parathyroid chief cells Effect of PTH on bone โ†’ increased bone resorption โ†’ โ†‘ release of calcium phosphate โ†’ โ†‘ calcium levels Induces RANKL expression in osteoblasts โ†’ binding of RANKL to RANK on osteoclasts โ†’ activation of osteoclasts Induces IL-1 expression in osteoblasts โ†’ activation of osteoclasts" Amboss

Not sure why D is wrong

+/- alexv0815(10)

Primary hyperparathyroidism: overproduction of PTH by parathyroid chief cells Effect of PTH on bone โ†’ increased bone resorption โ†’ โ†‘ release of calcium phosphate โ†’ โ†‘ calcium levels

Induces RANKL expression in osteoblasts โ†’ binding of RANKL to RANK on osteoclasts โ†’ activation of osteoclasts

Induces IL-1 expression in osteoblasts โ†’ activation of osteoclasts

Not sure why D is wrong

+6/- alexv0815(10)


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