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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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nesBaetm ermnbmae tniteriyg is the nrtaitmdene fo lful lnug orcreyve gflolinow yrunplmao i.nstlu

mSayr:mu

(1) ossl of senmaebt aemnrbem iyteigtrn is rtilcaci in mnindtgeier eth ont“pi fo on t”n,rrue dna steuorictbn ot the biyiltian ot teirhelssab nmroal lngu reetrccauhti hitw rmpioonto fo osisb;ifr

)2( lsos of pielelathi ,clles ndlteelhoia slec,l nad bemtsean emmenrba yrigtiten ni usalu tiialntriste annpmoeui dtcseasaoi ithw iiapdchtoi arynpolmu oisfisbr asled ot srdeodtye nugl rrhcitatuece nda aeteppurl osirfib;s

)3( ogmrtnarfsin gwotrh tcaβof-r si e,cesanrys tbu ton tenrylei tef,fsuniic to premoto earmpnetn ori;sbsfi

)4( tpeetrisns nteainnruitr/ijgn/rtaiy is iicltarc orf eth rgaaopionpt of ssrbofi;i

)(5 idahcpoiti uonylpamr sfsboiri si na eeplmax of a essrpco eedtlra to eth preetiesnsc fo na “ntgs,”na(i)e ccnoihr tnioammlia,nf nad robfi;iss nda

6() nueuqi lsecl rea itrlacic laerlcul arslype ni het grietaonul of .sfrbsoii

titcino:a5.oppsMP/ehc/:iimacgt2nnnl4/t2/1.v/C.46wsbclmtr./iwhw

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kernicterusthefrog  elLovy +
endochondral1  nya AF ro ahtmpao ro dulorw lanroeior?tc +
endochondral1  or was siht a dmro?an +
taediggity  peyT II tnmpeoeyscu veres sa teh tsem lecl orseurcp,rs utw/o eshot yoer'u remo or ssle u:ekfdc FA 2020 pg 166 +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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You veha to nthki uotba ti hsti yw:a the benmates eanemmrb si teh o”flscgand“fi on cwhhi o[vtretr]aeis ehlangi ucso.rc oS, y,se smte clles ytp(e II cenutmopse)y oluwd be nlvvoedi in hatt ehnliag osescpr utb yteh clo’tndu etsoerr teh almnro tarccheurtei (“no saaonib”tilr)em uwithot the setkle‘’on fo the esbemant ernammbe etnglil emth erewh to ,go in twah eidiotrcn to go,rw ihwhc ywa si p,“u” ect. If teh atsebnem arebemmn si rdoyst,dee uoy anc tlils gte ,nlaihge tbu ti ntwo’ eb grzaeodni haginel -- lti’l be adiizsgedron hlenag,i iwhch eosd not pepaar sa rmaonl seis.tu nriaizoe(gsdD nailhge si erbtte nhta on la,hnige but ithtuow a BM, eht ggrtaenenrie slelc ’odtn veha ayn trceo”ind“i dan rfrehetoe ntac’ retesor het maroln crehu)ettri.ca

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drdoom  by sit"e"teraovr i nmae alignhe hihcw reestsro eth verposui na(d omaln)r iseuts r.ccrhaeeuitt for hatt ot ppaenh, ouy ndee an ttican etemasbn nbmema!er +2
nwinkelmann  s,eY hits a aergt auymmsr to eht tosp by bubls@eb nad het itrceal eh s!dtepo oerthnA way to ktnhi of eht oeisqunt si ont, hawt essauc i,rpear tub wath sasceu rvbeiserreil i.jiyursnisr/obf athT ratelic xaldeneip an enexmetirp tath swdhoe aGt-TeFb saw esnysreac to aniettii ssfboii,r but fi MB asw tnciat nda taTeGF-b asw doerv,em eht ofbsrsii nt'did irtspse, e.i. acnitt BM is tcotevepir tgasnia TbFt.aeG- p.4hhspw/lP.iml/1i6Mra24/n/.twe5w.t/ob2cmctc/:snvngiC +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I dulow hinkt oolesrntui ovsvinel teh mtse cslel e(tpy II cpes)myotu.en Is eht anttci nbesteam bemmrane het wasnre uscaeeb it tilims seprda?

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aesalmon  I wdoul loas ielk to owkn if noneay nca rnaswe sith esqiunot - I saw ti sa a rtaSat e"no ,dya oen ,ewke eno "mntoh dink fo nqutiso.e Ist bbyrpoal yver ilspem ubt I still 'dton teg it +
bubbles  I poedst a ewn ecnmtom pixlgninea: steeambn mmnareeb ttyeiring is hte esnrsgtto etrnaitnmde of ullf xf ocrevyer gofonilwl pomnyralu unitsl ): +5
drdoom  uYo eahv to nithk aotub ti hist aw:y het setmenab bmenmare is het aio”dsfg“nlfc on hwhic tor]aetrie[sv lheanig s.cocru ,oS ,eys smte lelsc pety( II seemct)nuoyp lduow eb lonidvev ni htta inhgael opscsre tbu ythe utlncod’ treesor hte mronl**a reicheratuct “on( rti”o)balsmnaei wutohit teh ’enks‘oetl of the smanteeb meaermnb gtllnei htme rehwe ot g,o ni hatw rtideocin ot o,rgw hiwhc wya is u”,p“ ct.e fI teh aesmetbn mnbareme is yrddtosee, uoy nca tills egt lh,ngeai tub ti nw’to be anezorgdi ihlgnae -- t’lli eb d*aior*ngezids ia,lheng hhwci dose tno peraap sa rmanlo euiss.t agdDriszien(o enghlia si tbetre anht on ling,eah but twtouhi a ,MB eht nitgrergeaen lcles od’tn aveh yna ecd“o”iintr nda eoerhrfet tanc’ etorres eth lmoran certetr)ha.ciu +9
nwinkelmann  s,eY ihts a etagr ramumsy to hte spto yb belu@bbs adn teh tlcreia he dp!oets ohnetAr awy ot tihnk fo the enqusoit is ,tno ahtw scesua rpi,aer ubt twah aeuscs rieserreivlb isis/roibyunfrj. hTat artecli iapeldxne an tneixpemre htta ehoswd bTeF-tGa asw cseasreyn to niieitta bifio,ssr utb if BM was tancit adn Tb-tGeaF saw emordv,e eht ibforiss tdn'id srise,pt .e.i iantct MB is iceettovpr gnsiaat eGF-abT.t lnsenmhciaws6w/i4cC.2h5m/:br1pti.Plotc/w/n2.p4M/vg.t/ +



 +1  upvote downvote
submitted by ls3076(92)
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acn ynoena pnlaiex hyw ()D mltpaiaaes si r?oiccentr

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angelaq11  aebceus aealamtpsi owlud eb a snmoottranairf of the lmrnao techrctueiar fo the yeioarrtprs lethipmieu ot eno tath sdeo nto lbengo ehet,r in osersenp ot rcohnic nrtitiario. Tish wanmo adh oocacmnucpel uipnanoem ahtt swa crertycol ad(n I erad say pyloptm)r erde,tat so ehs rfdfeseu an eatcu tarhre tahn a hricnco ntu.isl +
blueberrymuffinbabey  uscbeea atlespiama i'tsn how eht olnmra erngaeaieernn/ilhtgo rnsesope nheapsp in teh e.vaolil het pyet 2 npmueeoscyt svree as semt lslrour/eccesrsp to ohbt ytep 1 and 2 yomepsecunt so teh ineeerogtran is nto ameia.tapsl +1



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