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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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msearapHdihiryyprto gniacsu obne soenisl si iva slOsbotaets cnagnsirie NKAR L- eiproesxns ot bdni ot ANRK no tocslsaseOt nad ilitamgsntu ehmt &t-g--; nic enoB noRtsirope

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pg32  iPkdec D deepsit idurtnaegnsdn eht oaveb ^^ beeuacs LI-1 si also kwnno sa oacstosetl tiatncvigai fc.t.rao. +8
plzhelp123  ^ I idd teh asm,e utb ti rpapase atth 1I-L ascatietv tostclaoses ni tpeillum omyl.ame hchiW ekasm seesn as taht si a olemasnp of inemmu ellsc hcihw can podrcue i.tieennurlsk +
caitlyncloy  anc ynanoe iaxepln why sith hte enwras si ECNA"AIPRR" aln?t?usioitm I lure uot hte cceotrr asnrwe uabscee i was cruitpgni AKRN adn NRKA L ngidi,bn ciwhh is tno ?irce!npaar +1
caitlyncloy  h..o it esme RAKN L is rteseedc to icaveatt hte ss.at.cl i wsa ntugicrip ti as KNRAL swa no eht casufre of the bta.sl cnrree: efe Jtmwpw/whhw:bs/tRuI.Oeseatce.uvoA/y=Botc?ht +1
makingstrides  If uyo ,can I Wduol ilhhgy drocnemem nigloko at eht tscheyk rhpma for st.hi tI ispxeanl hits we,ll in ym oopiinn, adn filyiedtne ldeehp m.e +
jatsyuk38  laGnoj I ducelv'o norws dias THP amutetsisl lastosseotb to rtecsee 1LI- ot iavcteat oasottlsec.s eH lsoa dias seoretgn rtpsvene oseotossropi yb itnibhgiin btoosaetls aelsere fo ve.o1rI.ewLh.- ehret is soal a roWUld seqnutio hrwee it idas RLA-NK alyps a oerm tamtripon lero aroct e(vor I-L)1 in TPH eidamted boen eadkrobnw +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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