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Retired NBME 22 Answers

nbme22/Block 4/Question#47 (reveal difficulty score)
A 56-year-old woman comes to the physician ...
Maintenance of basement membrane integrity 🔍 / 📺 / 🌳 / 📖
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 +14  upvote downvote
submitted by bubbles(79)
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metanBse nrmeemab nyitiegrt is eht eenmnardtit fo lful glun vrerceoy ilofnolgw lnauypomr ts.nuli

umy:ramS

()1 osls fo ntbemsea emnarmbe niyriegtt is crtiailc in gnreeinmdti teh itn“po fo on ru”tnre, dna rbuicenotst ot teh iilabtiyn ot rheelsaibts rlonam nugl cecreuihtrat hiwt tionmorop of si;ifbors

2)( ossl of lehiipelat esl,cl deatenhillo sl,cle and baemtens mereabnm nitiryetg ni suaul tnatetlirisi maiopneun satsiaoced ithw itachipodi aponmylru sibiofrs ealds to orddeyest ugnl hetctrciauer dan taerplepu sbsfi;rio

()3 fosrinmtanrg wohtgr t-foβcra si crayssnee, tbu ton elnretyi sf,fneiucit to mpoorte mrepentna sbiros;if

(4) pnitsrtsee /trtrtueganrinjiyin/ani is rilactci rof the rpnatgaooip fo soisbf;ri

)5( chidoaiitp nyropamlu iissfbro si an xameple fo a pscerso eredlta to teh itsecsneper of an ,g“s()tn”niea noihccr tiomf,mninlaa adn fss;ibori dan

)6( uiueqn leslc rae crliciat lllreuac relyaps in het lrgtenaoiu fo sbr.fiios

a:niotcitptni26e/C2crl4ai1/posm.gmt.:tPc4M/vns/5.iwlh/cwn.b/hw

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kernicterusthefrog  loyeLv +
endochondral1  yan FA ro pohaatm or ulwdro at?rnlicoroe +
endochondral1  ro swa ihst a onmar?d +
taediggity  yeTp II pcumeyonset eresv sa het semt ecll scsporre,ur uwt/o hseot yo'ure eorm or ssel fdku:ec FA 2200 gp 661 +4

Quoting Dr Sattar, if an injury or cut is too deep so as the regenerative/stem cells are removed/damaged - then healing can only occur by repair. Thus, in this case, the stem cells of the lung aka Type 2 pneumocytes reside in the basement membrane - so, injury to basement membrane would damage type 2 pneumocytes and would NOT allow restoration of normal lung architecture. That's why maintenance of basement membrane integrity is the most important determining factor to distinguish whether tissue will heal by regeneration (restore normal architecture) or repair (fibrosis/scarring). Same concept can be applied to skin (basal cells) and intestines (crypt cells).



 +11  upvote downvote
submitted by drdoom(1206)
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oYu avhe to nthik butoa it siht w:ya teh smetabne manbrmee is het ncf“daflig”so on hiwhc tr]serev[taio hgienla sccu.ro S,o sey, smte elcls (ytpe II uoseymc)petn wulod be vnliveod ni atth lnheaig crseosp btu heyt udlt’onc erosrte teh nolmar rrtthecuceai “n(o basaeim)ilontr” huwitot the lkn’t‘oees fo the sntaemeb emmerabn llntige emth erewh ot ,og ni htaw dnitrecoi ot og,wr wchih awy si ,p“u” cte. fI hte esntmbae rembeanm is oydse,drte uyo nca lslti get l,ehigna but it tow’n be gnoriedaz nhligae -- it’ll be nddrazieiogs gae,ilnh chwih does nto aeprap as ralnmo itses.u seairD(goizdn helagni is trebte ahtn no einl,ahg tub wohtiut a M,B het irgteagenenr scell o’tnd vhea nay tr“codniei” dna rteehreof at’cn troesre eht alrmon rteuca.ci)erht

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drdoom  by teiortar"vse" i maen geniahl wcihh ertoerss het suevpiro dn(a nor)aml siestu .rhuctaetreic rof ttha ot epnhpa, you dene na cttain sbmteena remnema!b +2
nwinkelmann  Y,es tihs a aregt rmsyaum ot hte ptos yb bbl@usbe dna eht lcieart eh tds!peo oerthnA ayw ot ihntk of the oiunsetq is n,ot wtah suscea rearp,i utb ahwt ascues brrrivieelse sirb./ouynriisfj athT arecitl xledepina na mpetirnxee atth shdeow aeGtF-bT asw ysanceesr ot atieniit sbsirfoi, utb if BM swa tcntia and FatbT-eG asw oedrv,me hte obsfsiir id'tdn rtpesis, .ei. tncati BM is eeitprctov sgtaian TtbG-e.aF sapshwin6cl./..i4tlwb/5t/Mn:rn/ghwe4cvmm1.Cip2tc2/oP/ +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I uodwl ikthn norleituso nolisevv eht estm lclse (ptye II onepuse.tym)c sI eth tcntia tnbsaeem nmaeerbm eht rwsaen ubeesac it ilitsm rade?sp

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aesalmon  I wudol osal ikel ot wnko fi yaenno nca eswanr stih neusiqto - I swa it sa a tStaar neo" a,dy eno kew,e eno mhnot" dikn fo esutiqn.o stI yloabbrp yerv silmep but I stlil otn'd egt it +
bubbles  I dsopet a wne eontcmm igiexna:nlp senbmeta mamrneeb iyirnetgt si het rsetntosg mttienander of flul xf vrrceoey ifollgonw nlauprmyo sunilt :) +5
drdoom  ouY haev to hnkit abuto it htsi y:aw hte esmtanbe ermenabm si the loscfg“fd”nia no ihchw oirsev[ett]ar gleinha csruoc. oS, y,es mtes slcle e(tpy II esotynu)mepc lwdou eb enoivvld ni tath aihgnel oesscrp btu tyeh ltoducn’ etorers het r*oa*lmn trihcecureat no“( iialt”aem)brson ttiouwh het e‘seolnkt’ of eth baeesmtn rebmeman litlgne hetm ewrhe ot go, ni ahtw oinridtce to ogwr, chwih ywa is p“”,u tc.e If the nembtesa erbmmnea is dy,etersod yuo nac tllsi get englh,ai utb it ’nwto eb dzeiarnog ghelain -- li’tl eb *dngrde*ioazsi nheag,il hciwh sode ont aeprpa sa anmorl tiessu. oasDgnz(ridie gilanhe is eetrbt than on elinagh, ubt twihtou a ,BM teh tignrgrneeea cells t’odn vahe nya nct“irdi”eo dna fhroeeert nt’ca tsoreer eth ormaln ret.)thrccieau +9
nwinkelmann  ,Yes hsti a eargt marusmy ot hte otsp yb bsbbu@el adn hte itleacr eh !edtpso Aohtren awy ot ntkhi of het tiosqune is to,n atwh sueacs repra,i btu tahw uscase erileeivrsbr rriisjibuo.ysnf/ Thta ralitce epeandxil an enermextpi that dewhso TteGabF- aws anycrsees ot naitetii iof,sisrb ubt if MB was tnaict adn tGFa-Tbe saw evr,dmoe eth bosiirsf 'itndd rts,ispe i.e. itntac MB si eitpeoctrv gnisaat atb-GTe.F nvP/46i/mr/42tcswCtw.1cgnhn/.pbp:.5.wslli2i/chaeM/omt +



 +1  upvote downvote
submitted by ls3076(92)
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cna oennya nalipxe yhw (D) aeslmiatap is ecnr?icotr

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angelaq11  buseeca plsatmieaa owdul eb a nattarfmisrnoo of eth omlanr iecattrcuhre fo hte ypaotsirrer heiltpemiu ot noe taht sdoe nto blonge eh,tre in respsnoe to corcinh iia.nirrtot isTh woamn hda eccmouolancp nupoimaen hatt asw rleccryot na(d I dera asy rpyptlom) dtert,ae so seh dfrfesue an uacte rhtare tnah a ricochn tsli.nu +
blueberrymuffinbabey  uasbcee laeatipmsa tnsi' how eht rnaolm oht/elaeggnraieernni seonresp aehppns in eth via.lelo eht yetp 2 motpeeusycn ersev as setm l/lcprsrsoucrese to othb tepy 1 dna 2 nsepoyetucm so eth ragtnieoeenr si not tseaimpl.aa +1



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