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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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aesnmBte bnmameer iiryttgen is eht eardntmntie of llfu ulng yrvoerec oolgfwlin luomyparn sn.ltui

Suaym:rm

1)( lsos of bamtsene rememban irnetytig si itccrila ni ntirngemied het ipot“n fo on ,nerut”r nad sctuitnoreb to teh ibtiinlya to brhatileess lramon nlug rehcetaciutr hwit oonmptori fo issf;rbio

2() ossl fo lilpeeihta c,esll laletiohned lels,c nad atmbsnee banmreme tgniyietr ni alusu tirsitilntae nanouipme eciostdasa hwti itoahpdici naurypmlo oissbrif dsela ot esdteoryd lugn cchrrteaeuit dan ppruaelte is;rbsfoi

3)( gminrfratnso owhgtr raf-tβoc is scsaen,yer ubt nto etneylir euncsif,fti ot mrptooe mnetperan fssiio;rb

)(4 nttreepiss rtg/erniat/ninntiriyuaj si iccrltia fro hte oantiparpgo fo irssfo;ib

(5) iacidtophi unypmoalr siorsibf is na mxlpaee of a soecspr dlertae ot hte nstpseeirce of an enst”)ian(g“, hcircon amamonln,itfi adn srsii;bfo and

(6) qeuniu lselc ear acrcliti cullaelr erapsyl in the gailonertu of rii.sbsof

oct iiat:n:4b4.se/cv/Can/grwh2phi6tnwmc/.c.n/Ml51/iittpPowl2sm.

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kernicterusthefrog  eoyLvl +
endochondral1  nya FA or oatmahp ro ldurwo tro?nicroela +
endochondral1  ro wsa shit a nrm?oad +
taediggity  ypTe II meceuostnyp resve sa hte stem lelc crepruo,srs uo/wt oesth eo'ruy oemr or sles u:dfekc AF 0202 pg 616 +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 aehv to nhkti tauob ti shit y:aw teh ntseemab aembmner is hte “nodgcf”falsi on hhwci [v]oresiettra naighle corcsu. So, yse, estm ellcs tye(p II yec)emnsutpo wdluo eb vevnidlo ni ttah nehilag sesrcop utb etyh ’clduton orstree hte nmalor utcrhartciee (o“n btmsolai”ina)re wottiuh teh leek‘ns’to of eth mneeatsb ameernmb nlgetil hmet eehrw ot ,og in thwa etniidcor ot rwgo, whchi ayw si u“p”, cte. If eht seanembt amreenbm si rsotdy,eed oyu can lslit teg elah,ngi but ti ’ownt eb raizegodn helagni -- ’ltil be sednzdiroaig in,lhega whchi seod not eapapr sa alromn eistus. geDrizadinos( eahnlgi si beetrt hant no eahgnl,i utb iotuhtw a ,BM teh riegtnrngaee lsecl notd’ ehva nay etnd“o”icri adn therrfoee ’cnat oeersrt eth namlro )c.echaurrttei

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drdoom  by tvoi"rsteare" i enam gnehlai which sstorere eth uivespro an(d lm)onra sueist e.harueccritt for ttha to h,appne oyu need na ttinca seabetnm rebenm!am +2
nwinkelmann  sY,e sthi a grtea syarmum ot the pots yb @sbelbbu and hte telirac he sopedt! teAhnro way to nkiht of hte tuosneiq is t,no wtha cessau aierpr, but ahtw aceuss liieerrbesvr yosniu/sfbrr.jii haTt aectlir aedelpinx an nxemrtpeie htta ohsewd G-tFTbae aws caesnyrse ot eiinitta iorbsi,fs btu if BM was icttan adn Fteba-TG asw medoer,v teh biorisfs in'ddt spirts,e i..e atctin BM is erpvetotic stigaan Ft-.GbeaT thw4goc5t2msmiCrl:it1/bP2./4M6hpiav/cpww/e//nn.nsc.l. +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I dwulo hinkt nruiloetso sivoenvl hte mtse celsl t(epy II euespcn).tyom Is teh tnatic nmseebta mrbaeemn eth wresna uebesca it stlimi sp?drae

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aesalmon  I ldouw aslo ilke ot nowk fi oneayn can sranew hits uqteniso - I saw ti as a tStaar no"e y,da oen ,eekw noe ntohm" dikn of eq.snotiu tIs obblypra very emlpis tbu I lslti d'ont get ti +
bubbles  I pesodt a ewn tmoecnm ilianenpgx: tanmeesb mbrnemea trnigiyet si eht ossrttnge emidtnteran fo lluf fx cveoryre ownoillfg rolmynaup sntuli ): +5
drdoom  ouY vahe to htink otbau ti tshi ayw: eth entsaemb rbmeamne is teh nlcoag“”idfsf on hihwc t]etveai[orrs iheglan uscrco. ,So sye, stme lecsl t(epy II sey)oteupmcn douwl eb odilvenv ni that ngehail escrops ubt yteh u’ncoldt rtseoer hte r*lnao*m uerhtcreaict n(o“ ”lstaobi)nrmaie utohtiw hte ‘n’oketsel of hte mnebtesa ernbmeam nilletg them erhwe ot o,g in wath encdtirio ot g,wro hhiwc way si ,”u“p ec.t If teh bmstenae rebnamme is e,oetdsdyr uoy anc listl get e,alhing but it ’nowt be enaodrgzi lahgeni -- t’lil eb dgraiz*sedoni* ginleha, cwhih dose not appear sa amroln tseui.s asg(Dnidorzie lgianeh si ttbeer anth on anelgi,h utb ttwhoui a ,BM eht rggrteeianen leslc tdno’ ehva nya ”ei“irtdnco nad eehrofert t’cna retrseo eth noamlr ercc.ah)etruit +9
nwinkelmann  ,Yse this a gtare myusmra ot eth ptso by ebbs@bul dan hte irectal he !dpseto Ahtoner ayw ot khnti fo eht siutoenq si n,to waht ucasse e,pirra utb awht cuaess rrebilvesrei fbir/njsuoyr.sii hTat crliate xlaediepn na pmnixretee htta hewsod ba-FGtTe was yasnesrec ot naiiteit sbioi,rfs utb fi BM was ctiatn dan GtFeTab- was ov,eredm teh bissfrio dnd'it spietrs, ei.. ianttc BM is etvitperco tignaas tTea.Gb-F tmoi.Mt/ml/w:.vn/ePn/pg6wc/4nah4lhwir1Csp2b5ctc./.i2s +



 +1  upvote downvote
submitted by ls3076(92)
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cna aynnoe xnepila hwy )D( ptiaemasal is ntcriecro?

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angelaq11  scuaebe ptealsmaai ulodw eb a rfosaontrnitma fo eht anlmor uhiretretacc of het rstoipyrrae euptlheiim ot eon ttah dsoe ton elnobg e,htre in nssroepe ot nrohicc .arniritoit iThs wamon had culmepncocoa meiunpona hatt wsa yrertlcoc a(nd I read ays ypltprmo) eat,rdet so hse uredffse na acteu reahrt tnha a cniochr is.lntu +
blueberrymuffinbabey  ebuesac easpmlaait tsin' how eht omnral renarenitnoeli/haegg osrpesen sppnahe ni het l.aloeiv teh ytpe 2 sueymoctnep eesrv as mtes crrsoescerslpu/l to obht eypt 1 and 2 cspoeumnyte so eth ognrereitean is nto ataspiemla. +1



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