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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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setaBmen mrnbeema greintiyt is hte ttdrenaemni of lulf ngul cervyeor ofnlolgiw ymupnarol nit.uls

mmaruy:S

1() slso of sbanmtee rbmneaem tntiigery si arclciti in ediintnrmeg hte tni“op of no ”rtue,rn dna tscnbtiuroe ot eth ianyilitb ot seblhsitear mlanor ungl etrrceaituch twih nmpitrooo of f;ssibrio

2() sols of etehialpil cesll, eendhtaioll llcse, nda tnsmaeeb bameernm ertyiting ni alusu ianirtietslt aeinmopun iscaosdaet iwth tiicpdaiho nurymoalp sfribosi dlsea ot rddeseoyt gunl theiaerurctc nad elptepuar rofsibs;i

3)( mnrogasintrf rhtwog cof-taβr si ,acerssyen ubt ton neyrilet tife,icfnus ot pomeort nmeetrpan isrisof;b

(4) tsnrpietse atrn/iaurntnyj/teiiingr si cilictra rfo the iratoogapnp of oiif;sbrs

5() dtcihopiai unyamorpl srsiifob is an exelmap fo a rscopes ltedaer ot eth sersicpenet of na ”nase,)t“g(in cnrocih iali,fnammton nad ;iibfssro nda

6() uuiqne selcl aer cciilrat lclaelur epyarsl in hte eairlougtn of fbso.srii

ti no:acitg/vl6/iC5phpnm/i1/bm.sw//Mecns2wlan:2tc4t4trhio.w..cP

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kernicterusthefrog  yvelLo +
endochondral1  ayn AF or pthmaao or wrlodu tr?oaeoilnrc +
endochondral1  ro asw siht a aor?mnd +
taediggity  eTpy II nueoeytpscm vrese as het emts lcle rprru,escos wot/u ohets y'uero oerm ro esls de:cukf AF 0202 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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Yuo vhae ot kntih abtou it iths y:wa the tbaneesm mermneab is eth d“caflisnof”g no ichhw a]tsv[tirroee hanilge .cocsru S,o ,esy tmes elcsl eytp( II tc)nmsyoueep uwdlo eb iedlvnvo ni ahtt liahgen ssercop tbu eyht ou’cdnlt stoerer het anrlom cttueicraher “n(o ol)srbiait”eanm toiuthw eht e’nlt‘oeks fo het bsanemte aemmbenr inletlg meht erweh ot go, in waht inodctire to ,rgow whchi yaw si u,“”p e.ct If teh aesbtemn mbeeanrm si drtseeod,y you anc slilt gte gleaihn, but ti ’ntow eb eigarondz eihlnag -- lit’l eb nrgdizidsoae lhnaegi, hchiw dseo otn rappea as rnmalo es.suti idgrieszonDa( elingah is eretbt hatn on aleihgn, tub witothu a ,MB het geerinrngaet lselc ondt’ have any “terdnicoi” and fehteroer cnat’ rtseoer eth lmoanr cr)uatec.iterh

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drdoom  by otsieaertrv"" i anme eilhgna chwhi eetosrsr eth osurevpi (nad )rmlnao sstieu tih.terarucce rof hatt ot p,ehanp yuo edne an aintct mesatenb enmar!bem +2
nwinkelmann  ,Yse thsi a egatr uymmsra ot het spto yb ebbbsu@l nad eht ariltce eh tsedpo! rhAteon awy to ihtnk of het qtuionse si t,on hatw ascesu erpri,a btu htaw sacuse bieerisrvelr yi./jfisrrbuosin aTth eacitrl lepaedinx an emeitrnxpe taht hodews -FbTateG asw earnysces to iietinta sro,iisfb btu if BM was nttcia and abtTF-eG aws emre,vdo het siofisrb dnid't srstie,p .ei. nittac MB si irtpcetove saagnti Fa-e.TGbt ics./nh51pin4crpsmcw4b6:tMh/lat/w/l/wevtonCmg/2i.2..P +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I ouwld ihktn otrneousil vesnovil eht tsme cllse (ypet II p.oescyuet)mn sI the iacntt tensmabe enrmemba the narwes ecbsaue ti sltmii ?erasdp

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aesalmon  I olwud laso klie to oknw fi noynea acn ewsnra shit nutisqoe - I swa ti as a rStata one" y,ad noe e,kwe noe hmotn" ndki fo e.notsuiq stI oyrlbapb ervy psemli tbu I litls o'tnd gte it +
bubbles  I eodstp a nwe mocnemt agn:pxielin neseamtb eenmarbm tngreitiy is eht gnossertt tmanteerind of ulfl fx orreecvy lionwgofl lmyurpano sutlin :) +5
drdoom  oYu evha ot thkni obaut it ihst :ywa teh ntameesb meemnabr si eth f“giodnl”sacf on chihw sreoe[rvtai]t heginal rc.uocs So, ,sye tsme celsl tyep( II nyepsmuot)ec douwl be vloveind in htta nhlaeig rscsoep ubt thye oducntl’ reroset hte am*n*lro icruratteceh n“(o ranilibt”oes)am uttoihw the s‘tneo’elk fo eht aesnbtem enmrameb iegnltl emth eherw ot ,og ni athw ntcioierd to rgo,w hwcih wya is p“,u” tc.e If eth baenestm enembram is ederdtoys, ouy acn lsitl egt gelni,ha but ti owt’n eb idegozrna nihaleg -- itl’l be nagso**iedrzid ihlngae, ciwhh sdoe nto erapap sa nalrom i.ustes Dirsgoian(zed egiahln is tebetr than no aeinlgh, btu htitwuo a B,M eth iegrgaeetnrn celsl ’dton aveh yna onrdc”iiet“ dan eeorrefht anct’ setrero teh mlraon aehcre.i)tutcr +9
nwinkelmann  esY, siht a etagr asmmryu to the ospt by ebl@busb and eht larecit eh deot!sp tenAorh yaw to itkhn fo eth nsiqeotu si o,nt atwh uasesc i,rarep tub htwa esasuc reeribresvli u.fisriryjinobs/ Ttha icaretl pielaedxn an imnxerepte htta shdoew -GaebFTt saw srseyncae ot aittneii ,frobisis utb if MB aws inatct and GaFeTt-b aws mveo,edr eht bsforisi 'idtdn rep,stis .e.i ttnica MB is titcroevpe ansgait GTb.ta-Fe 44r2wgs2./phlni1hpcnb.Pm/ntvw/./t/6.isicm/5Mwt:oCacle +



 +1  upvote downvote
submitted by ls3076(92)
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cna aenony aienxlp hwy )D( aelaitspma si ortec?inrc

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angelaq11  caesueb tapsilaame owlud be a imosfaatnrontr fo het nmalor rtcaeiheruct fo eth toyeirrrsap pihmteueil ot eon thta esdo tno bgloen eht,re ni sseneopr to nihcroc n.traiitrio hsTi anwom had ccpceoaolnum onanupiem ttah saw tecrlrcyo na(d I raed say pr)ypotml teaetd,r os hse efsdurfe an ueatc hearrt nhta a cornhci l.nitsu +
blueberrymuffinbabey  aesebuc meaalsapit i'snt ohw the lromna regelnii/nhaearogetn peessnor npeaphs ni the i.velola eht tpey 2 uctmneeyspo sreev as stem rleeorrplcus/scs ot hotb tepy 1 dna 2 uoeysmctnpe os eht ganereirotne is not leasapita.m +1



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