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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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neBsaetm rambenme ginttyrei si eth ntidaneertm fo lful gunl eeyvrrco flwiogoln uaymplron .tnsuli

umSyma:r

)1( osls of mbseaetn benmamre tgtnriiey si laticrci in rdmneigtnei the tn“ipo fo on ,rn”eurt nda stoencribtu ot het iniaylibt to asteiebhslr aonlmr lgun etchrriaucte wthi poonrtomi fo iifrssob;

(2) sosl fo lelapeiith csll,e hlateieondl cls,le dan sanetbem emerabnm rntieityg ni sulau tiairitlnste euoipnnma dosstiaaec thiw tiohaicidp lprumyano oibfsrsi sdale ot eeyrdstdo lngu iertrchauect dan pperaulet i;sbsfior

)(3 nagtmrnriofs wgorth ocβatrf- is en,ssacrye tbu not ilneeryt etnicuisff, to eopotrm paetnmren rs;bisofi

4() strtpeiesn nnitrraini/tayiget/njur si ccraltii rfo hte gpantiporoa of obif;sris

(5) doiichpiat rpunyamlo isisrbfo si na lxemaep of a ocpsers tadelre to teh iecsesrepnt fo na as)ntei(”“,ng corcihn tmnln,aamifoi nad srsf;biio adn

6() uneiqu slcel rea licticra eclulral yspreal in the ignlroutea fo rfi.obsis

acotii:ntlgcr1/P6.//t/4cw2mwec:apv/inb4Cw.2sthtl.5sn/.phiminoM

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kernicterusthefrog  Levloy +
endochondral1  yan FA or htamapo ro ruwdol orro?laiecnt +
endochondral1  ro wsa this a mdroa?n +
taediggity  Tpye II enpytsmuoec rvsee as eht mste clel sorsucr,rpe u/tow tseho u'orye oerm ro elss fk:udce AF 0220 pg 166 +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 heva ot ntkhi outba ti sith awy: teh etsnebam remamenb si eht “ifsglncdfa”o on ciwhh eirostert[]av heangil cocrs.u ,oS s,ey smte cslel (eytp II pueotc)yenms dolwu be ldnoeviv ni atth hnelgai spsrcoe but eyht touldnc’ erortes teh larnom eithcrrtcaue (no“ bma)os”rneliait hwituto teh lk‘tso’nee fo teh nmebeast bmrmeane igleltn mteh eewrh to ,go ni whta retidicon ot ,rgwo wihch yaw is “p,”u etc. If eth nmaetesb rbnammee si ,rtdoyesde uoy acn litsl get lenihga, utb ti ’twno be zneogaird ealhign -- tli’l be ioidzasegrnd ,ginehla wchhi osde otn aprpae as olamnr t.isues gaDsnizreoid( elhgnai is ebetrt htna no ,ehalgni tbu hutitwo a B,M teh etingeernrga escll tdno’ have nya nriid“etoc” nad eethefror c’tan terreso teh nmlaor hauee)i.rrtctc

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drdoom  yb airtrv"oste"e i eamn elanhig ihchw seetrrso the usierpvo nad( arlnm)o tiseus ir.eateccthru fro ahtt to npeh,pa you eedn na cnitat amebtsen !aremmneb +2
nwinkelmann  Ye,s siht a rgeta sayrmmu ot eth psot yb bubbles@ nda eth litacre eh stp!oed ortAehn way ot nkthi of het qonesuti si ,tno wtah ssaecu raep,ir tbu atwh eucsas iirrlbreesev irsn.ifbj/yusrio htTa rietlca ladepnexi na xenemtirpe that hwodse TFe-tGba wsa csrnesaey to aintiite ribs,ifso tbu if MB was tactin and abe-tFTG was r,oemedv the ssoiibfr tnidd' istpe,sr ..ei tnitca MB is oepirecvtt ntsagia tG-F.beaT wpClPri1:wtwvho/n.alsnset.4//2.Mcpnbtc4.i25h6mc/g/i/m +1


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 +1  upvote downvote
submitted by shaydawn88(8)
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I uldwo ikhtn itlruseoon nevvolis teh mtes leslc (tpye II o.)tepumsynec Is hte cattni emansbte brmaneme het rsenwa uebaesc it iitlms arpsde?

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aesalmon  I wludo losa ikle to okwn if nonyea anc wsaern hits unsqioet - I was it as a taatrS n"oe yd,a neo ,week eno hmto"n iknd fo eo.qsnuti tsI baorbypl vrye elmpsi btu I sitll dnto' etg it +
bubbles  I epstod a wne memntoc ieaplgi:nxn matesbne abenermm ttrgnieyi si het srtnsgoet ndeanmtetir of lulf fx oerreyvc lngwilfoo nrlpomuay sitlnu :) +5
drdoom  Yuo hvae to iktnh butoa it tish :awy het neaestmb nmbraeme is het iadlgoff”n“sc on which [atrerseitv]o nelihga sc.ruco ,oS esy, stme lcels tpey( II ncmteue)opys odwul eb vevnildo ni atth einglah oscsepr but ehyt ’nuctodl seortre the ma*r*lon retreacuchti “(no mni”taaleis)bor thwiotu eht sloe’te‘kn fo hte nbsateme eberamnm lignlte them eerhw to g,o ni htwa oienictdr to ogrw, wcihh awy is u“p”, c.te fI the etamesbn emneabrm is ,etodredys you acn llsti egt l,ghenai tbu it onw’t eb ignazoedr aeinlgh -- ll’ti eb ddnzieri*osag* hna,geil cihwh sode not paaepr sa lnoram .tussei oesDazidgnri( ahiglne si ettber nath no nlage,ih tub tohwtiu a B,M the iegnarrtgeen sclel ’odnt avhe nay iitnd”cor“e and reotfeehr na’tc rteseor teh oamlrn .reu)ceachrtit +9
nwinkelmann  esY, htis a rgtea rmauyms ot eth otsp yb lsub@beb adn het laierct he pe!ostd hoAntre ywa to knhti fo teh sqontiue si nt,o twah uescas eir,apr btu awth ausces ilrvereierbs f.jssyibo/rnruii tahT etarlic eaxlndepi an etiepmernx tath ehwdos TGeabt-F asw ecnryaess ot niieitat i,brsoisf utb if BM swa aittnc adn -aGTFtbe was mdreoe,v eht rsosiibf i'ntdd ierts,sp ..ie aictnt BM is vpeterocti gaasnti T.e-tFabG isc/2mrhw5etcP.ii4gh/1/Mb/p.6wl/t.lsn:ntC.2apw/nmvc4o +


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 +1  upvote downvote
submitted by ls3076(92)
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acn ennoay iaelxnp ywh (D) plsaaaeitm si o?cnietrrc

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angelaq11  uaeecbs ataepslmai dwolu eb a ramnortnsfotai of het olramn utheircactre of hte paryreroist peemihiult ot one htat seod ont olbnge htre,e ni srosepen ot crihcon iiorrtti.na sThi onwma dah oaeconpmcluc pinnaueom tath aws ccrtlorey da(n I rdea ysa otrmpyl)p teadte,r os seh reffdues an etacu rathre athn a choincr isn.lut +
blueberrymuffinbabey  esuecba mlaetaaips si'tn woh the nlamro eerhetinieanolg/ragn eosprnse hpapesn in hte e.aloilv het ypte 2 costpeynume rvees sa mest /eelrulrcsscrpos ot thbo ptey 1 dan 2 yutmesnopec so teh taeienrogenr is tno lm.teaaapsi +1


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