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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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ysoapiydtpeihmHrarr aincusg eonb solneis is avi tsOosbesatl reciannsig RKNA -L sopsxireen to nbid ot NRAK on sslsctoOeta nda ginuiamltts etmh -g;--t& cni noBe nRotesprio

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pg32  dcikPe D eidtpse dasdiurentgnn het eoavb ^^ ecbsaeu -1IL is soal nwnko sa sotsalocte titagnicaiv .ctrof..a +8
plzhelp123  ^ I idd eht esma, but it rsppeaa atht L1-I iactvetsa stoalsteocs ni lmlitepu myaol.me iWhhc kaems neess as that si a lsmanpeo fo imneum llsec chhwi nca eucropd l.neunirstkie +
caitlyncloy  nca enaony xnlapei hwy thsi teh nwraes si AR"PARECI"N n??timsouailt I reul otu eht rtoeccr swaern abseuec i swa urinpcigt RKNA nda NRAK L ngdib,ni hwcih si ont acp!nrraie? +1
caitlyncloy  o..h it esem NKRA L si erestdce ot ctaiavet teh stac.ls. i was uicngiprt it as RNAKL swa no the euasfcr fo teh bla.st nceef r:ree teO?wubecJRsatwh/ypwIhs..tv/oAuc:tw=ehoB/tm +1
makingstrides  If yuo cn,a I luWdo hyglih rmmenecdo lnigkoo ta eht esthyck hapmr rfo .hsti tI alxepsni iths w,ell ni my noi,npoi nad ntieiflyde phleed e.m +
jatsyuk38  olanGj I vc'lduoe sonwr aisd PHT mtlstaiuse slssobteaot to eersect L1I- to avteatci coseatsolt.s He soal siad neseogrt stenervp issroepoosot by gnbiithnii tbaoltesos lsereae of o.vh.Iwe.1r-Le rhtee si aslo a WrUdlo osuetnqi rwehe ti siad NR-LKA ypsal a reom rampitont roel ctaro r(ove L1I)- in TPH dteaiedm eobn ekarwdobn +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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