NBME 20 Increased osteoclast maturation and activity (NBME Answers)

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Retired NBME 20 Answers

nbme20/Block 2/Question#7 (reveal difficulty score)
A 30-year-old man comes to the physician ...
Increased osteoclast maturation and activity 🔍 / 📺 / 🌳 / 📖
tags: endo PTH

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submitted by cafeaulait(11)

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I eiveble this stem may eb irgneirnf NEM 1 mosenydr - ilboseps oaitanmgrs picetp( culer eeadiss x)d, rapraotiydh edna,amo nad yutpritia noaedam asugc(ni .DASI)H ut,B oyu dtn'o ende ot eenv onwk hsit ot egt tihs thgri - usjt sagkin the eeffct of hhig HPT no het estsym - suecas iecsnraed lotsotcesa tiictayv as lwle sa mto.aiarnut

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fatboyslim Teh yosptmsm of thsi itaentp era edu ot peihcareacmyl tos,n(se nsoe,b ongrs,a NHOERTS d[aieesrnc drsi}seu,i nad yhscciptiar oven)seto.r yrlapacmeieHc can also cause cetppi eucrl asei.sed So eht prryami thaoopgyl si rdrayhpiato oyna/aeapsamdierphl cianusg eth ahreempclaiyc +6

beetbox Deso aoyenn wkon twsh'a pu tiwh teh o'n labemnisotair ni hsremuu ayrd'?XiD ethy ujts owthr ttha ni for on sr?enoa I ogt hodkoe on it, I utothhg etreh was no ansiecerd acstsetloo iic.vtt.ya. orisweeht hte croilatc esobn udowl ahev nebe dodly ihnt ro oisetmghn +4

topgunber NEM 1 - P P P . aardPht,rioy rgsnrnatas(ecipa in ihst ,csae) rutptiayi l.esnio ton yke to siawnengr tihs ounetpits.q oemsc hwti msstypom fo ciharce,epylam ,onsam nosra,g rtnheos ipge)en(, yscph rooLt.ok vsneeo at htp adn liuc.amc we ese hgih ac dna hgih hp.t eW nkwo taht hghi ciaculm dwuol wreol s..thp.hit ansme eht ighh uailmcc aws eud ot eth ihhg htp (i..e hitoypdrara omanoa)ueidenQst is lcyaalut nksga:i hwat rae the eftsecf fo H?TP a, c, otpoiesp fo TDH P adn E i eeibdlve 'atenr ltreade ot -TH dounPBSs tgsheniom leik teh tepaessgihon fo duoFaayetsr rhi-mypopsiehpd we ntiielfyde know hatt HTP issrceean aC , so yb nnriageisc acstelsoot vrmiaao/cutttnyaiit ouy teeaiblr icaulcm noti eth olo.bd hsti si eht bset nsrwea. +3

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submitted by ∗laminin(18)

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nca enomeso lianexp hyw ti assy eh ash an ian'ttc' PTH n.roco.ae.scinintt ti ot tel su nwko ttha eth PHT renoitoanncct si a sertlu of ayptodgal? ohn ash'tw shi dx? n!stkha

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yotsubato I wraes ehty ekma up esom fo stih st.uff iekL twahs pu iwth teh i,tstrh i,anonuirt adn pecipt ucrel aeds.isse +9

redvelvet cpemlrhiyaaec nac aecus rhgnoenpeci tseeiadb dpuni;sis so ,thirst ur.oaiinnt elecypmhrcaai cna lsoa caesu eicptp ruelc eis.eads sHi smtpsoym ear all obtau ihclceapymera ude ot repsyrhoamhiatpdryi. +4

namira aemecrp"Hiacyl nca seuac reanl iscntyonufd cshu sa neiorhegnpc beatieds npsidusii )(,DNI utb het smnmecsahi enlgdrinyu mdihaapcedu-enrlyiecc DNI rea otn lwle tnu.ed"sro dowl9yea/-it5/na00hlt/lp3w:dSlii8een7on)-ktft0c-(n02terw48t3/s6a.5rurg1.toxi/ +2

dulxy071 Why a'cnt eth rrcocet naerws eb C) hihwc sintpo twdrsao lnear feai,ulr wcihh yma aled to aocrsneyd spaamedhhriityprryo ihgnav the mase urlsest I vbeiele +2

pmofmalasia The odnryecsa imirphdayeyroasphrt ni naelr euliafr is eud to ssol fo cumlcai in teh iuinotnng-nncof dyin.ke nI siht niostueq the cmulaic aws dteal,vee os yuo can erlu out areln liuer.fa +1

sars apeacH-lmyriec sscaue sotsne (lucmaic ,steo)ns aogrns ,i)otno(sciatpn oenrhts cadeisrne( o,aruiin)tn snobe eceidsr(na ctseasotlo atioitan)cv, nad cpyitrahsci ortnoeves des)pi.o(ersn +1

epiglotitties austoo@tby olas sa emesoon edometnin in artnhoe conemtm, i nhkti eehyr't ngithni tath eth px gthim heva E.1NM torrdyiaPah -pasrypialhe ramhpec,aclyei ytiuapirt amdean-o DSHAI +ntiih(ras,tn)tirou and ainacpcetr -utomr agmstainro ctepp(i ucrel d)esiaes +

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submitted by killme(14)

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ehT ctenpco gnbie destet si wa"ht deos HTP od ttha elsda ot emacpecahl"riyo.Pp.i:ghgae/icV3t/sbds/K/bpn.timj

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yotsubato hg,u ishllu.tb I swa rtying ot igrfue tuo na aclatu sdsiaee ropsesc e.rhe +7

rio19111 ist ryrpima thhiraroraiypeydmps esduca by opiytrdarha a.moeadn dinaitod fo het epcpti ulcre eugtgss oelZnglir g;&--t- E1NM u bt neon fo atth si mip bcaeues tsth'a nto ahtw htye are nsa.kgi All etyh era kaings orf si eht tnncifuo fo HTP. +3

topgunber NME 1 - P P P . oPirtydhaa,r crasnaesirpag(nt in hsit )ea,cs ytuitpria l.onsie not eyk ot eiwasrnng stih .qutoi npste socem twhi mtmpsosy of mhaie,carplcey omas,n gnaso,r shtnero ng(pe,e)i cshyp ooetLk.vsorn oe at pht nad iccluam. ew ees hhgi ac dna high pht. eW onkw atht ghhi lcimacu duolw worle ht..hpi.st mnesa the ighh clacuim asw ude ot eth hghi pht ..(ei rptyarahdoi oasnQn o)eaidtmue si ucalytla aisnk:g waht era eht tsceffe fo PHT? ,a c, osteoppi of DTP H dan E i eeevblid te'nra leedrat ot PnouTsSdH-B toisnemhg ikle the eesintogpash of eprdoairysptioh yedua-mFpsh ew yefidelitn know htta HPT isnaresec aC , os by igecsrnnia tcoselosta vctayi/mttiaoranitu yuo iberltea icmaucl onit the .oodlb tish si het tsbe ea.rwsn +1

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submitted by ∗sympathetikey(1600)

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nI itdonaid ot PTH = coesaltots yicvitat = aeresicdn u,iccmal this onesrp ulodc also be ntgibxieih osmmpyts of 1MNE.

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topgunber MNE 1 - P P P . rthaodiyr,Pa snatercsga(pairn ni shit a,sce) uypiitart .soelin nto eky ot ensrwniga siht seuon.qtpt i emocs tiwh tpmsyoms of har,eplyeaccim ,nmosa asrgon, etrnosh ei(e)gpn, chpys eLvtnsooeoko.r at thp adn a.clcium ew ese gihh ca dan hhgi th.p eW wokn that ighh cualmci dwulo ewrol tp.s..ihht enmsa teh hihg lmiucca aws ued ot hte high hpt .i(e. riradptahoy eoaaenit )snouQmd is aulclaty g:kinas htaw aer eth cteesff fo ?PHT a, c, ositeppo of P DTH adn E i edblieve aten'r ltreaed to Tu dH-sonPSB tsemoihgn kile teh stpnoseahgie of huiaeatmprFo dy-ispdhreospy ew lifdntyeei know ttha HTP seinerasc aC , so yb ncnrgiseai easocsoltt vmtittairitac/ynuao oyu berlatei aimclcu into hte lo.dob hsti is eht sbte ne.wsar +1

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submitted by rio19111(16)

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its prrmiya yrriythpahodrpemsai ucesad yb thdraaopiyr nda.aoem diaonitd of hte peptic lucre gusetsg loeinlgrZ -t&-g-; M1EN

tub onen fo ttha si imp baecuse sath't otn waht ythe rae sgink.a lAl htye ear ngiaks orf si hte tufconin of TH.P

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rio19111 otns,Se srago,n rt,hnsoe cpraicyihst nrseeovot &--;gt- spysmomt +1

topgunber NEM 1 - P P P . Ptadyorrah,i ies(rrpcanagtsan ni isht ce,)as pttuiaiyr ioesnl. not key to nigawresn tshi pnqio tetsu. oesmc iwth syopmsmt of ,ieceahylcpmar ,nmaos nraosg, rtshoen iee)np(,g yphcs ntoskLoeoroe.v ta pth dan mccauil. we ese high ca and hgih .thp eW kwon atth ighh caumcli oudlw welro hsi.p.tth. amsne eth ihgh iccamul wsa deu to het hihg tph i.(e. hodyrritaap mtoiadsoueen)Qan is auayltcl agkin:s waht aer teh sefefct fo ?HTP a, ,c oostippe fo PHDT and E i eldeibve ran'te trleade to BHondTPsS-u omhesintg lkie teh osgaensetpih of -h eshprypsyrauetoaidpiFdmo we tfieieldny wnok hatt PTH ecnsisera aC , so yb rnesacngii ocsasoetlt anytcmotaitv/iutari uyo etrelbai cculaim iton eth loodb. sthi si eth estb w.reasn +1

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submitted by ∗nwinkelmann(366)

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soDe nanyeo oknw eht saiecifincng fo ocmnteoy imytol?it

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submitted by arthur_albuquerque(1)

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Wtha ehledp em to earwns thsi noe iquet ilsyea aws hte fololgwni orlani:eta

iayelrHcepamc + hghi PTH ;-gt& piyr"rma am"padryitiyreshorph

woH od ighh THP elad ot ?lermyepaiccha egnricasnI tclosastoe tcvtay!ii

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submitted by ∗topgunber(68)

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EMN 1 - P P P . ,trPyhaioard (acrintnsrsapeag in shti )seac, rtiauiypt eilon.s ont eky ot wegrinasn ihts oq.nisteu

pt meosc hwit ompsymts fo amehlaeypcc,ir smo,na anr,ogs etnhors in)gee,p( yshcp eteno.svor

okLo at thp dan uaclm.ci ew ees high ca dan high .hpt eW nwko hatt hhig luacmic odluw lwroe thp.hst.i. amsne eth ghhi mclciau swa eud ot eth hgih htp (.e.i otraidyprah ndoaame)

niousteQ si alaltyuc giaksn: hawt rae teh feeftcs of HP?T ,a ,c oiseoptp fo HTP

D dan E i vleedbei at'rne daelrte to TPH

-nBoSsdu tnehgoism leki hte asphtoeenisg of piyreepsdmuytrpioaohsadh

F- we yitlieefdn okwn atth HTP scesarien Ca , so yb easicingnr osotlstcea rta/citvoatmtiiauyn uoy leierbta uacmlic iotn teh .blood sthi is eth ebts snae.wr

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