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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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tyhisHiraeyprrodmap naicgsu bone nsleosi si aiv ssttlebOosa eicgnnsira RKNA L- rsesoexnip ot ndib ot KNAR on Osslctsetao nad gusitnalitm hmte &-t-;g- cni Bone Roernpoist

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pg32  Pkidce D deisetp sgianddnuntre hte voaeb ^^ easeubc -1LI si losa nnowk as astotlseoc vttaicagini r.t.fc.ao +8
plzhelp123  ^ I did het mesa, btu ti psperaa htta 1I-L ativtseca cotssltaeos ni etipllum loymmae. Whhci akesm eesns as ttha si a nesolpma of iuenmm csell cihhw anc oeprudc uk.neslinrtei +
caitlyncloy  can anoney nxlapei wyh shti teh snawer si PRRA"EIN"AC ?oluin?ttiams I uelr uto the tcocrre anewsr uesacbe i saw rigincupt KNAR nda RNKA L niig,dbn hiwch si otn !paa?icernr +1
caitlyncloy  .h.o it mees NARK L is dceretes to vittaace eth al..stsc i aws gcriniupt ti as KRANL wsa no eht csufrea of het .tlbsa ce erreefn: =Ioetua.vw:.ucR/bAmy/wheJwtOt/ottsphh?ewsBc +1
makingstrides  If ouy ,anc I duWol glhyih mdecmnreo igolnok at eht ysthcke hprma for hits. It paelsixn hsit l,wle ni my op,noini nda dyniilefet ledphe .em +
jatsyuk38  oGajln I edl'vouc oswrn aisd HPT sttemalsui tsleosostba to eretsce I-L1 to aevttica lcsssteaoo.t He laos idas rnoesgte tveprsne ostoroespiso by nhibginiit obsotseatl rleeesa of Iov-w..hree1L. ehret si slao a rWdolU sutoqein ewerh ti sdia RL-KNA alpys a rmoe prtmtonia reol otarc ore(v LI)1- ni HTP emadetdi ebno rwbakedon +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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