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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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etrysyrrmappoaHidhi gunisca noeb nlioses is avi asoelbOttss gnenicasir ANKR -L soineprsxe ot idbn ot RNKA on asotOlcstes dan gtsntiluami mhte ;--t-&g nci enoB renRotsoip

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pg32  edikcP D etpdesi undeatgsrndni het ebvao ^^ seacbeu IL1- si oals wnnko as stceatsool tvitgacaini ..ct.froa +8
plzhelp123  ^ I did eht sema, tbu it aepaspr tath L-I1 ivacestta lesctoasots in lulipmet mmoy.lea hhciW smake neess sa that is a somepaln of mieumn slelc hcwhi cna cupdoer rkentus.nieil +
caitlyncloy  cna enanoy pnaixel why htsi eth arnesw is "AR"PECIRNA il??onmstaitu I elur tuo hte troecrc arwnse csueeab i wsa utngcpiir RNAK dna NKRA L ,inngidb ichhw is tno !eraiacpn?r +1
caitlyncloy  .h.o ti msee RKAN L is etcresde to ivettcaa eht s.c.salt i swa ringctipu it as LKRAN asw no eht uarefcs fo the sb.lta fr:neceee r suc/hewwteJ.:opR/.vsw=IcwmtyhOeaAutto?h/bBt +1
makingstrides  If ouy cn,a I dlWuo hgyilh necemomdr knigolo at het stykche amhpr rfo ts.hi tI xlepsain sith e,llw ni ym oipinon, dan fydnetliie heepld e.m +
jatsyuk38  ojlaGn I ledvcu'o swrno aids PHT ietusstmla seobsltsato to eetercs IL1- to iactveat eoostl.stcas eH loas iasd tegseonr rnvpeste oesopsotsiro by ngbiintiih ostoetabsl eeaersl fo 1h-I.eo.Lwe.vr erhte is asol a rWdUlo etsoqnui eewhr ti idsa RNA-LK sypla a oemr mpitaront orle toarc ro(ve L-)I1 ni TPH tdidaeme noeb eaobdrwnk +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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