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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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atyeaHsphimroidrpry gnicasu oneb ioeslsn is iva bOottlesass nrisicneag KANR -L xsopsnreie ot nibd to ARKN on solssOeattc nad iuttnglaims tmeh &-tg-;- cni oeBn oRonsiretp

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pg32  edkPci D itpdese nadtgseunidnr the bevoa ^^ uascebe -I1L si asol wknon sa otlosatsce vaiaiicttng ac.fto.r. +8
plzhelp123  ^ I did het aems, tub it prpasea tath I-L1 saaevctti cososetalts in llmuitep .laoemmy ciWhh kmesa nesse as ttha is a lspnoeam of mineum cslle hhicw cna odcepur kteniseirnlu. +
caitlyncloy  anc onyena pelnxai hwy tish eth nrsawe si IPAREARC"N" oium?tlsa?nit I luer tuo het ctorcer rneasw eacbeus i saw punrciitg RKNA adn KANR L ibnngid, ichwh si ont cna!er?riap +1
caitlyncloy  h.o. ti emes KARN L is dcsretee ot ieatcatv the cs.als.t i saw puctiginr it as KRANL aws no eht cureafs fo eht stlb.a :rfe receen .twyat.eowORthsptJuoecIsc/:hAwbm?B=/tvhew/u +1
makingstrides  If oyu c,na I ldWou yihlhg mdmnroeec koongil ta het ksyhetc hramp rfo tihs. tI xlpesani this ell,w ni ym nionp,oi nad eityeldfin lphede e.m +
jatsyuk38  oljnaG I e'lcvodu rwosn iasd HPT tsmaisulte slotbaessto ot sectere -I1L ot vaicetat .estcaolssto He aols asdi storeneg penvrste psisooorotes yb iignbitinh btoaessotl aeeersl of how.-.1.veIrLe erhet si alos a rWUold tenuosiq ehwer ti sida N-KALR plsay a rmeo tnmioartp oerl raotc rve(o -I1L) ni HTP eediadmt oenb rwbodaekn +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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