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Retired NBME 22 Answers

nbme22/Block 4/Question#47 (reveal difficulty score)
A 56-year-old woman comes to the physician ...
Maintenance of basement membrane integrity 🔍 / 📺 / 🌳 / 📖
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 +14  upvote downvote
submitted by ∗bubbles(79)
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eemtnaBs eanbremm tretigniy si the andittnreme of full lgun ycvreero nowfgioll rylamunpo n.ltsui

mSary:um

1)( slso fo eatsnbme rnebmema rginteyit si rcicilta in itmenirndeg hte itopn“ fo no n,r”rtue dan outirbnestc ot eht iyitbanli to hiteslserab nmlaro ugnl ricetrutaech twih oripotmno fo fib;iorss

)(2 loss of iielhtlpae sll,ec oletihlaedn llecs, nda tseamben nmaberem rietinygt ni suaul tiintasterli upnnoemia aaiedostsc wiht piihoitdac pmnaourly sfsbriio dalse to etodedsyr ungl etuhacrtirce nda treueappl i;siorbsf

()3 frrmnosnigat horwtg -rtafβoc is aesens,cyr ubt not lenyitre fecuni,tfis ot tpeoorm anmrpnete sbirosi;f

4)( esstepirnt i/nn/rnnttaiugteraijriy si aliritcc rfo the itgarpoanop of bfri;oiss

5)( ictiaihopd nrupmaloy fssbrioi is na xlmpaee of a csrseop detlare to hte tescrniseep of an sn)g(ti,ea”n“ occrhni amil,mnaitnfo dna b;srofisi nad

6)( iequnu sellc rea rcliacti uacerlll erapyls in eth uatoilnreg fo ir.osisbf

t:oicatni 6p.rmhltwtspl1/ac4hCP2/.vgs45/nc.m:i./i/boiM2wnenct/w

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kernicterusthefrog  Lyloev +
endochondral1  any AF ro oapmtah ro rdowlu arclo?retnio +
endochondral1  ro was htis a dnao?rm +
taediggity  eypT II cumoeseynpt vsere as eth mtes elcl pousrrcer,s u/otw tsoeh ureo'y mreo or ssel euf:kdc FA 0022 gp 616 +4

Quoting Dr Sattar, if an injury or cut is too deep so as the regenerative/stem cells are removed/damaged - then healing can only occur by repair. Thus, in this case, the stem cells of the lung aka Type 2 pneumocytes reside in the basement membrane - so, injury to basement membrane would damage type 2 pneumocytes and would NOT allow restoration of normal lung architecture. That's why maintenance of basement membrane integrity is the most important determining factor to distinguish whether tissue will heal by regeneration (restore normal architecture) or repair (fibrosis/scarring). Same concept can be applied to skin (basal cells) and intestines (crypt cells).

+3/- abhishek021196(119)

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 +11  upvote downvote
submitted by ∗drdoom(1206)
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oYu aehv to tkhni otuab it itsh ywa: eth abtmense rmmanebe si hte gnafcflsodi“” on hihcw tirea]teo[vrs ehnliga so.cucr oS, s,ye smet slcle e(ytp II snutey)pecmo lwudo be ielnvdov in thta hgailne osscepr ubt yhet dtlcoun’ retrseo het noalmr rtearthcueic n“o( b”asmirtinloe)a ithwtou the ‘lonskt’ee fo hte absmtene enmabemr geiltnl temh weerh to og, in tawh ieotcnrdi ot gow,r icwhh yaw si ,up”“ c.te If hte batemnes mrnbeaem si ,reoetsdyd uyo cna lsilt teg ianlhg,e but ti t’won be dzrnoaegi eilhnga -- ltil’ be isdarzgneiod ngelh,ai cihwh dose not ppeara sa lnroma e.stisu zineD(dgsoria lhganie is ettber tnha no ,lngeahi tub ittwuoh a B,M het airreeeggnnt sellc no’dt evah nya rncoit“ed”i dan refethreo antc’ setrreo eth omalrn rrc.eaietu)tch

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drdoom  by roser"itave"t i amne hngeila hhciw ereosrst teh riovusep n(ad )olmran seutis rtteec.cuhira rof taht ot anehp,p yuo dene an aictnt senmteba eambrnem! +2
nwinkelmann  e,sY tshi a rtage msmauyr ot eht ostp yb bluesbb@ nad eht etcirla he !teposd hAotern way ot nkhit of eht esniutoq si tn,o whta scsuea e,prira but wtha sacues reireevilsrb sbri/ojifnrs.iuy ahtT eiclrat dapxneeli an ixmpetenre ahtt eoshdw bTt-GaeF asw caeysnser ot ettinaii f,rsiibos ubt if MB was anctti nad -beFGTta aws ,dvmeoer the iirfbsos t'dnid rpt,ssie i..e iactnt BM is pteotvcrie taiasng G-T.tFabe Cmval/6hw2/b/tl4cig.nnr/1hi42otse5mcpwscwn/..P.tpM/:i +1


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 +1  upvote downvote
submitted by shaydawn88(8)
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I lowud thikn nrtuoelsoi slievnov eth mste lecls te(py II meto.u)npsyec sI teh ainctt smabeent nmeabrem het resnwa bsecaeu it itslmi ae?dspr

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aesalmon  I wloud oasl eilk to oknw if noyean anc ewrans itsh osteiunq - I swa it as a attrSa on"e ,ayd noe kwe,e neo hn"tom ndik of ionsqtu.e tIs oprlabyb vyer smepli but I tllsi o'dtn gte it +
bubbles  I osptde a enw ncoemtm xagin:lienp etbaesmn enarbemm gyttnirie is eht entgosrts tdamnnriete of lulf xf rrevycoe wlolnfogi urlnoypam niustl :) +5
drdoom  ouY ehva to itknh abuto ti sith aw:y hte msntbeae rmemaebn is teh fcs”faidl“ong no hwich etoesi[ratvr] elnahig .srcouc ,oS ,yes tsme cesll tpy(e II ustnceoy)mep uwldo be evdnvoli in ttah lhaieng epsosrc utb tehy cdul’nto toresre hte *omlr*na eerutchriatc “o(n t)ln”mariseboai tuohwit the teslko‘ne’ fo eht tbeemans bnarmmee entlgil ehtm herew to og, in hatw tcniiodre to ,rwgo hwchi ywa is ”up,“ .etc fI the abentmse arebnmem is tedyrsod,e uyo can sltli etg a,nhlieg ubt ti w’not be gdioaernz enahgli -- tli’l eb gdsrzedion**ai ega,nihl hhiwc sdeo nto paapre sa lmnroa .ssteiu rzisoeDinda(g ahlneig is rteteb tanh no nia,hleg tbu htitwuo a B,M het taeirgengern llcse o’tnd ahev nay roine“ticd” dna ereehtofr ’ncta tsereor the anmolr )etraeictucrh. +9
nwinkelmann  ,Yes siht a taerg suayrmm to eht psto yb belub@sb and the lrcieta he poeds!t rohneAt wya ot ntikh fo teh snuqtoie is ,not tahw cuesas irp,era ubt waht eucass erleresvbiri ns.frobjiuii/syr tTah actierl xnedpalie na inxepreemt htta dseohw -FbaTeGt wsa ancsyerse to titneaii rosfibi,s but if BM wsa cnttia and aGtTb-eF asw ver,moed hte ifsroibs 'itndd sierspt, .ie. taintc MB si erotcvtpie tgianas FeGtb.Ta- cw6a1b/rc/e.44.ml/wlcnnw/5sPsiMtC:.gh2ot/ivpnp/ti2.hm +


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 +1  upvote downvote
submitted by ∗ls3076(92)
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acn oenyan xlpaein yhw (D) aaalstemip is tinocrce?r

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angelaq11  beasuec litspeamaa ulowd be a tnraansifomort of het nlrmao etarucctreih fo eth artrsyopeir meihlueitp to one htta dseo nto genobl rhete, in ponerses ot rncochi iiitator.rn ihTs moanw dah lcomacuencop mnnioaepu that wsa rtelyocrc n(ad I reda say mppoyrtl) eatrde,t so seh ufdrsfee an cueta rrteah htna a ichnroc iln.tus +
blueberrymuffinbabey  sebueac mealtpaisa tisn' ohw teh ronlma rieeenig/ghoanenltar enposers spahnep ni the .lioeavl het tyep 2 ospeutnmeyc reevs sa stem oeusrlrprcslcse/ to htob yept 1 and 2 pyecouetsmn os het gitneaonerre si otn .esilaatmpa +1


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