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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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Bateemns emmrenab gieitnrty is hte nmntetreadi of flul nlgu rveryeoc ownilgofl mroalupyn .itlusn

:mSamryu

)(1 olss of neamsteb erbmenam giteinyrt si cciitlar ni dnieientmrg teh inopt“ of on rret,”nu nad etiotcrnubs ot eht itlnaibyi to leiethssabr anrmlo ngul tchrtuiaecre wtih oomponitr fo sioi;srbf

2)( ossl of haelleptii cl,esl iotheealnld lecsl, and smabntee brmeemna yeittnirg ni asuul ttrniailtsie epmonanui seidaasoct twih ptdaiochii naoplyrum boissirf aesld ot doysetedr nglu cerhettaruic adn lrpetupea ibors;fis

3)( rgirmtoansnf htwogr -oβctrfa si rcne,sayes ubt tno yetlrein tn,ifieusfc to rtmeoop emrtenanp ;bfsisroi

()4 resnetitps iyrtnaurigtnijnnit/ear/ si tcacliir rof het rioaotnpgpa of sriis;bfo

(5) ohapictdii yolrupamn bfssriio si na lmxaepe fo a crpssoe raletde ot the eeecitprnss fo na ,)ntg(a“s”eni irhccon fainnlom,mtai adn srbi;iofs adn

)(6 ueuniq slecl rea cirtalic laueclrl esrlyap ni teh iarotgluen of sio.bsrfi

aicto n:itg2.4spvtmpnswi//lCi5on:/bw/.hP6cie1.ttcamM/nrcl4/hw.2

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kernicterusthefrog  olyevL +
endochondral1  nya FA or pmaotah ro wulodr ocnrait?eorl +
endochondral1  or swa shti a moa?rdn +
taediggity  yepT II yomneteucps evers as the esmt cell srrrusec,po t/wou hseot oy'ure erom ro sels fcd:kue FA 0220 gp 661 +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).


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 +11  upvote downvote
submitted by drdoom(1206)
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oYu evah ot hiktn oatub ti tish :wya the bmaenste nemmbaer si eht gsaffdl“on”ic no whhic soivretr[eta] eglihan o.crsuc ,oS ,yse stem elscl ytpe( II msoc)entuyep wudol eb ldievvno in ahtt ianglhe pscsreo ubt yeht udtc’lon reorest eht rlaomn eiacrhcrtute (n“o bioentl”s)iamra tiuwhto teh ’s‘etnleko of het mtaebsen ambmerne gitlnel hmte ewerh ot o,g ni atwh ditcneroi to wgro, hihcw ayw is ”p,“u tc.e fI the amsetenb maenrbme si dyseerto,d you acn still egt ,lhneagi ubt it to’nw eb izrdneoag iahgeln -- ltli’ eb dgeianrdiozs ,lgenahi hhiwc soed not paearp as oarnml essiut. Drgieodaszn(i ngaelhi si tbetre ntha on nhielga, tub othituw a BM, eht eerngtiengra ellsc ndot’ have nya “”idioenctr nda ohfreeter an’ct erroste eht naroml trcee.hc)iatur

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drdoom  yb tsteeavoir""r i neam gilhaen hhciw tsrorees hte upiorvse n(da ml)oarn itusse tcue.itaehrrc fro htta to aenphp, uyo eend na acntit btmaesen !nmmebaer +2
nwinkelmann  eY,s siht a aegtr syumamr to het tspo by s@lbubbe nda teh cilaert he epst!do rneothA awy to tkihn fo eth unsetqoi is no,t htwa usasce rie,rpa tbu waht suaces rerielrsevib rsj.ruifisny/boi Taht ecrltai leednixap na peexrminet atth oedhws aGtb-FTe swa esyransec ot iiniaett iobfs,irs ubt if BM swa acnitt dna -eGTaFbt swa oemdve,r eth rsoibisf it'dnd rpets,is .i.e tactin BM si eicveotrtp sngiata t.TFe-baG /2speco44n/6imati/whvMsirnwp15t:hc../l.Cwl/m2bPc./ntg +1


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 +1  upvote downvote
submitted by shaydawn88(8)
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I owdul ktihn etrusoionl envislov hte tsme lcsle (eypt II p.tmeesunyo)c sI teh nttica snetaebm eaemnbrm het ranwse bsceeua ti miltis esr?pda

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aesalmon  I ludow salo ilke ot know if enonay anc newars sthi qiunesto - I saw it as a Sttraa neo" ,dya eon we,ke one tnhm"o dkni of oesqtiu.n Ist oplraybb revy lespmi tbu I lsitl d'not tge ti +
bubbles  I tdsepo a ewn etcmonm gpxeainil:n astbeemn aerbmmne irtnygeti is hte sttosregn naettdnremi of lflu xf ryoerecv fnooiwllg aprnuymlo utlnsi ): +5
drdoom  ouY aehv to ikhnt baout it ihst aw:y eth temsaenb bemmerna is eht scgoffn”alid“ on ihwch se[]avroeitrt gneilha ocrscu. ,oS sey, esmt cslel etp(y II eyoumtp)escn wudlo be ovivenld in ahtt naeilgh eoscspr tub htye ctunlod’ sorreet teh a*mn*lor urherctcaiet o(“n ae)nb”asrtiomli iwuotth hte soenk’te‘l fo teh atesnemb mmbnaree tngeill ethm rwehe ot ,og in thaw dionticer ot r,gow cihwh yaw si up,”“ cte. fI hte tenasbem aenmebrm si dtoeey,rsd uoy anc litls etg ,galneih but ti nto’w eb gnzideoar gilhaen -- llt’i eb zrndo*e*dsiiga legn,hia hcwih edos nto aeprap as rmonla s.uesit agoeziniDdr(s egailnh is rebtet nhat no aighen,l ubt wthtoiu a ,MB eht regienanterg lecls ndot’ vhea nya roei”ncid“t and eefoerhrt c’atn terrsoe teh omnlar h)cri.actrteue +9
nwinkelmann  ,eYs ihst a rgate uramyms ot het sotp by bl@esbbu nad hte lartiec eh sptoed! hrentAo ywa ot ihknt fo the qsuioent is n,ot twha ucsase r,iaepr btu what seusca rrbelvieirse njiyubrfirossi/. tahT ateclir nepildxea an ienmerexpt ahtt heodws bt-eGFaT saw aeecsyrns to ientatii ofrsib,si tub fi MB wsa atctni nda aetF-bTG swa emver,do teh bsoifris tdnd'i stirspe, e..i tantci MB is pcrvieetto taigsan -.GTeaFbt cltvb../stmP.ni4:ha5inh.w/62iwrmlw/Cgcc4pM/p2en1tos// +


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 +1  upvote downvote
submitted by ls3076(92)
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acn naoney inpelxa hyw D)( lmsiaaeatp si i?ncrtecro

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angelaq11  easeucb lpeamaiats odlwu eb a mfnotoartsniar of eht nmloar treicuactreh fo het eporirrytsa iehtieulmp ot one atth dsoe ont nelgbo eehtr, in ersnoesp ot icohncr rtiinr.iaot Thsi mowna adh cmoaceucopnl uonapeimn ttha asw lcrrytoce dan( I ader sya opyt)pmrl ta,rtdee so she ruefdefs na teuca rrahte htan a icncroh nusl.ti +
blueberrymuffinbabey  aesubec spitlaaeam it'sn how teh olnram inee/aathgigoeerrnnl eerossnp spnapeh ni the aeil.lov hte etyp 2 pmteyuoescn svere sa tems srerlscceupslo/r to btoh eytp 1 dna 2 pyncosuteme so the rtnegaroeeni is tno eal.masaitp +1


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