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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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ripyoaHrydrtiempash aicusng oneb nslseio is via tsoltesbaOs inrgcnsaei KNRA L- pienxoerss ot bdni ot AKNR on sasstOotcel dna nualttigmis hmet -g-&-t; icn Beno oRoietsnpr

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pg32  kiPedc D tdiesep enaintgddrusn eth obaev ^^ eeascub 1IL- is soal onknw sa otalosecst gtniavaicti .cf.t.ora +8
plzhelp123  ^ I idd teh ms,ae btu ti earsppa thta 1-IL cvitaaest lasescotsot ni uetlpmli mo.laemy hhciW esmka eenss as htta si a nspeaoml of uemmni lslec chwih nca ucpedro nustenrelk.ii +
caitlyncloy  can eyonan eliapxn yhw itsh eth wenars is RPAENRCA"I" itau?mois?nlt I rleu out the cceotrr srnwae buacees i asw gtnuripic KNRA dna ARNK L bi,ngidn hhicw si otn erapiac!nr? +1
caitlyncloy  o..h it emse NKAR L is retedesc to aticetav eth st.cs.al i saw ticnurgpi it sa KARLN aws no hte sfcaure of hte s.atbl c:en eeefrr swoeImh/eRswyecu?AwOphtt.:/btcvh/uBtao.J=wt +1
makingstrides  If ouy c,na I oWdlu hghyli mncedmore likonog at het cteyskh maprh rof ih.st It xpenlias thsi ll,we ni my nioopi,n dna dlineiftye dehple e.m +
jatsyuk38  nljoaG I 'eulocdv wnrso isda HTP emuistsalt ltbeaosssto to tesrcee L-1I ot iaevcatt ssolcetst.oa He oals dsai genroets rnevstpe opitesrossoo by itbngiiinh obsatstoel arleees fo h.we.oLr-.vIe1 hreet is lsao a lrWdUo seuiqton rwhee it sdai NKARL- plyas a mero ionttparm erol rtaoc rveo( -L)I1 ni HTP edmdaiet oenb eanokbdwr +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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