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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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pg32  ideckP D dtpesei gennrudatnids teh voeab ^^ ucebase L1-I is soal knnow as slosaoctet iavigtcitna rat.fco.. +8
plzhelp123  ^ I did teh eam,s but it papaser ahtt L1-I tasaectiv cotoasesslt in mtlulipe laoy.mme hihWc eakms neses sa ahtt is a smpeolna fo inmmue sclel chhwi cna epdrcuo .snnirlkeietu +
caitlyncloy  nac eynaon eaxnipl wyh shti hte nswrea si CRP"ENRI"AA t?tilousanm?i I rule tuo het cortrec sewnar sbaucee i wsa ictpgruin KANR dna RNAK L indibn,g hwchi is otn nrr?aiae!pc +1
caitlyncloy  .o.h ti mese RKNA L is edsecter to cvitaaet het ca..sslt i was uigtcinrp it as RAKNL aws no het urfcsea of teh s.blta cneee r:erf vottaw=c.toJ:eBIw?htOhumch/uy/bps.wAeRt/swe +1
makingstrides  fI yuo ,acn I udoWl hyhilg eommednrc knoliog at the tshekyc rhamp rfo .itsh It xlanesip hsti llew, ni my n,oinoip dan fetynledii pedlhe m.e +
jatsyuk38  Ganjol I deoc'vul nwros dais PHT utlsasetmi essoltoasbt ot etecrse 1LI- to tivteaac lc.osasestto eH asol aids eosgnret tpensrve tssorioosepo by bintigniih sesaottlob seaeler fo vh-IoLeer..w.1 ehetr is aosl a lWdroU qinsteuo whree it dsai NRA-LK alpsy a meor ranotmpit lroe acort (rove -)1LI in TPH emetidda enob rnadekobw +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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