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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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osdrmHiieahtrppayyr aucgsni oben ilneoss is avi bselstOstoa saiengrnic NARK -L inpoxsrees ot idbn ot NAKR on sOttleoascs nda migutailtsn emht ;--tg-& cin enBo ristoepoRn

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pg32  kPidce D ipeedts aenudndgisrnt the oevab ^^ eseuacb 1IL- si loas knnwo sa tslseacoto tnativgiiac f.cr.at.o +8
plzhelp123  ^ I idd the e,mas utb it raeapsp atht -LI1 ctevaasit stelosctsao ni eltlmiup omymale. Which mkeas ssene sa ttah is a nplsoame fo eimumn selcl ichwh can ecordup reuisnli.kent +
caitlyncloy  nac neonay nxleiap why tish teh reswan is P"IARNAR"EC au?iltms?iont I elur tou eht ecorctr wasner eescbau i was ruiigntpc RANK adn NKRA L ,dninbgi ihcwh si nto praaer?i!cn +1
caitlyncloy  h..o ti smee ANRK L is ctreedse ot attivcea eht sacst..l i wsa rgnitcpui it as NLAKR swa no teh fcraseu fo eth bta.sl :eneer efrc /Bwaw/mwIuJ:/otb=..echtttvocu?sRehtpewyOhAs +1
makingstrides  fI yuo an,c I Wluod iyglhh moncederm goolnki ta the ehctkys phamr ofr ihts. tI axselpin tish ewll, ni ym pii,onon dna tifdylenei lehdep e.m +
jatsyuk38  jaGonl I d'vceuol wsnro said HPT taimtlsues sotetoblssa ot trceees 1LI- ot ttcaavie tlsssca.teoo He laos dais enrsteog vteneprs oopeissrtoos by hiignbtini loastsbtoe eesreal fo rI.eL-ohv.1.ew heert si sola a odUrWl iotqusne rehew ti asid K-RALN alsyp a ermo rtompinta erol atrco oer(v )L1I- ni PHT eedmidta enbo dbnoakewr +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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