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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  dkeicP D tpeesdi entdsadnnriug teh voaeb ^^ csubeae L1-I si oals nnokw as tstacosloe vtiinacagti cf.ator.. +8
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caitlyncloy  anc nyanoe eilnpxa hyw itsh eth rwasen is A"CEN"RIPRA tlnoimu?at?si I lrue tou hte errccto warnse cbueeas i asw gnctiipur ANKR nda NKRA L ndgini,b ichwh is tno p!ainc?arre +1
caitlyncloy  o..h it esem KARN L is eetrsdce ot actvitea teh .lt.assc i aws irgtunpci it as KLARN was on hte fsuaecr of eth tasl.b ee rnfcer:e uwhwo:.IthJeO.vo?hswcewB=pcmabttuAtyes///tR +1
makingstrides  If oyu ,cna I oludW lhihgy mcdrneemo oloinkg ta eth estyhck rhpma for i.sht tI niaxsple tshi ,wlel in ym o,pnoini dan lyetifdein epdelh .em +
jatsyuk38  onGjla I olcv'edu orswn dsai PTH tmstauslei baeostotssl ot tsreece LI-1 ot iatvecat so.tleoatscs He sloa dsai egntroes enrtpesv rosiooepotss by iinitinhgb estlboosta selraee of -oerw.v.1eL.hI heret is saol a doWlUr eqoistun eerwh it iasd RL-KAN ylpsa a eomr ntioptmra lreo ctroa evor( 1)LI- in THP ietadmed ebno nobakdrwe +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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