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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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yppasoaidrmHrihreyt isnacug beon leiosns si iva ltsOasosteb nciengaris KNAR -L isxnrpseeo to dnbi ot RKAN on etssloatsOc dna aiumgntltsi them ;g--&-t nic Beno ponteriosR

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pg32  cePkdi D istedpe rduennnigdsta the avbeo ^^ beecaus IL-1 is soal nonwk sa soatotecsl atgaitivinc aor.cf.t. +8
plzhelp123  ^ I did hte ,aems but ti parsape ttha I1-L ttcaavsei otasoessclt in ptlemliu lyo.aemm ihcWh samek nsees sa atth si a lpaesonm fo nuemim cslle hicwh cna cdeopru nstiukenler.i +
caitlyncloy  nca eaonyn iexapln hwy sthi eth rewsan si CAIRNPREA"" utti?aisn?olm I elur uto het occertr nrawse euesabc i was rncpitiug ARNK adn RNKA L i,dnginb hhciw si ton pcnara!?ire +1
caitlyncloy  .o.h it eems NRAK L is sreceted ot vatacite the .as.tcls i aws utngcripi ti as RKLNA wsa on het scefura of teh tbl.sa cefenere :r /tvOtacet/Js?yse/wBApwohcuRhmt=w:eoIhb.uwt. +1
makingstrides  fI uyo cna, I dluoW ghhiyl dnmereocm oolngki at het styhcke hmpra ofr i.tsh It siapnexl iths wlel, ni my iiopo,nn dan iydeftelin plehed .me +
jatsyuk38  ljGoan I cdl'vueo owsrn isad TPH iamletsstu soatltobses ot creetse 1LI- ot ictvatea s.loeotstcsa He slao sadi ernetsgo tnersvpe sesotospoori yb tinnhiigib oeltbsatos seearel of erwI..1ohL.-ve rthee is olas a rWoldU oniusqet reehw ti disa RL-ANK salyp a reom mtntiapor eolr rctao (oerv L)I1- ni HPT edmediat neob bedkowrna +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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