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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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Btenemas eabmermn ntrygtiei si hte tenetmnrdia fo full glnu creroevy nlgfoilwo marolupyn t.usnli

mrua:ySm

1)( lsos of ebsmtena mmraeebn yingttrei is lctiirca in rmditnnigee eht ip“ont of no ”,rtenur dna rsbuntcotei ot eth iiibatnly to btrssleeiha nrloma ugnl uhtecrrcetia htwi nirtpomoo fo rsoisb;if

()2 ssol of elaitieplh csll,e ieaonhltdel ,lcels and tbnmseae eebrammn ienirygtt in luaus sitrtitainel pueianmon dcaesoista thiw ioachipitd lrmoupany fibrioss delsa ot deesoytrd nglu tirccuetehar dan talruepep firbiss;o

)(3 frarsnomgint wgorth ar-otcfβ si aernyecss, utb ont tnryiele tfucfiiesn, ot motorep rnpmeante is;fsriob

4() isprtsneet nreryagnt/uirnn/jiiiatt is irtilcac orf teh tnaorgpopia of of;sibisr

5() aticipoihd aomlrnupy rsfioibs si an lapemex of a rpoecss ledtare to het esnsrctepei of an ,gn(n“tei”a)s noccirh mtmalfniinoa, nda biro;isfs dna

(6) uqnieu lcels are alcritic calelrlu rpsaeyl ni eht eingatolru fo ofbrssi.i

actotini :i:wo..gcna2vPhetl/c6b45r2t4w/lpsmisM/c/.wt.n1ihmnCp//

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kernicterusthefrog  ylvLeo +
endochondral1  any AF or moahtpa ro wduolr ?lnoecatrrio +
endochondral1  ro aws tish a ?oamnrd +
taediggity  eypT II psecnuyetom esvre as teh mtse ecll erprosurc,s ow/tu eohts 'ureyo meor ro less ck:uefd FA 0022 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).



 +11  upvote downvote
submitted by drdoom(1206)
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uoY vhae ot inkth buato it siht awy: the nstamebe ebmearmn si het “cfalsn”dgfio no chwih o[eireatts]vr hienlga urc.sco ,oS sey, tmes lscel (pety II smoye)petcun wdlou eb oivevldn ni taht alehnig sopcrse btu ehyt cdluot’n sterroe the oarlmn etictuhrecar “n(o oemtsr”i)bnalia tiuhowt hte eltek‘n’so of teh esbanmet mmrneabe ngietll mhet ewrhe to o,g ni ahwt riiecndto ot w,gor cihhw ayw si “”up, c.te fI teh emsabnte anmmbree is oedrsye,td uoy cna lltsi etg he,lgain ubt it ’notw be oeairdnzg ailegnh -- lli’t be rsiaeozidndg neliga,h wcihh esod ton pparea sa ormaln su.etsi (nozedisDirga alhinge si ttbeer than no ,gilhena tub thuowti a ,MB teh nregerniaegt slcle ’notd ehva yna dre“i”tnico dan erorefhet a’ntc tsoreer the onamrl ut.reearciht)c

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drdoom  by "evtart"oreis i anme eiglhan hichw esoterrs eht ispovreu (dan m)nlora tsesiu rhaeitu.ertcc for htta ot pepna,h uyo eedn an ncatit neesatbm rmbem!nae +2
nwinkelmann  esY, ihts a getra smmyaru ot teh tsop by ubes@bbl dan eth eicalrt eh dts!ope hroenAt way ot ihtkn fo hte iqsnteou is ,ton what ecasus ,reriap tub thwa seacus ibervrieelrs rrsjsyi/un.bfoii thTa ticrale aiedxnpel an mpineterxe thta wsohde tFeTbaG- swa yresasnce to tiaiinet br,sioifs tub if BM swa titnca and aeTFt-bG swa eermvod, eht iirsfsbo nitd'd ,siprets .i.e taitcn MB si reeovptcit gisanta FGate-T.b wscirp/no/h5llws/a.mCteb:i4m/ht/pvntgn.26/2.PcMc41iw. +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I owuld tknhi erliuoonst oievnlsv the smet lecsl epty( II t.peysneo)cmu sI the acntti smteaben enbmaemr eth nwsrea ucaseeb ti tmisli a?epsdr

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aesalmon  I uolwd loas iekl to wnko if aeonyn acn newsar hist steoniuq - I asw ti sa a atSart "eon y,ad eon eewk, oen onhmt" ikdn fo osneiqt.u stI pabrylob very ismlep but I iltsl dno't teg it +
bubbles  I oseptd a ewn temcnmo genxlian:ip ebentmas emrbnaem etinityrg si the tessrntgo einamtnretd of ulfl xf eorvyerc olnoilgwf polyarnmu ntuils :) +5
drdoom  You hvae ot thikn utboa ti tsih ayw: the steabnme abnmrmee is het dcg“”offlnsia on ihhcw tviera[str]oe gilenha sruco.c oS, ,yes esmt elscl (ypte II teyco)punsem dlwuo eb lnovdvie ni tath ialehgn porcsse tub ehty nlud’toc rostere teh *l*orman teecrruticah (“on s)”oairaeitbmln hiotwut het lnos‘t’eke fo the emsnetba earmbnem gnltlie them rwehe ot ,go in htwa oeticdnri to gowr, iwhhc ywa si p“”,u t.ce If eth namtsebe mneaerbm is erys,doedt yuo acn tlils gte laighe,n btu ti ’twno be irdoaznge glihean -- il’tl be *sdg*azdrniioe ng,haeli wihhc deos tno appear sa olmarn utse.is reizsoaDd(ing igaenlh is trbete thna no ,egialnh ubt twhiotu a MB, the gaieegnnrrte sclel tdo’n avhe yan eo“tnr”iicd nda ftroreehe cant’ soteerr het roamnl ua.tcri)terehc +9
nwinkelmann  Ye,s isth a agtre uyrmsma to teh ptos by @lbsbueb dan the ctraeli he epod!st nterhAo ywa to itkhn of eth eqisount is ,otn ahtw secusa erapri, but ahwt acsseu sibrlevreeri rsbynu/ros.ifjii Taht tarielc ilexaepdn an ieeepntmxr atht sohwde bGetaF-T saw eracseysn to teiiiant sii,brfos ubt if BM wsa tcatin dna TFb-eGta swa vmeerdo, the irsfbsio idnt'd essrpt,i .i.e cntait MB si epievtocrt gistaan aTG-tF.be i:hi2mna4c/pgMtlw4pwvsi21c.onr/ePt5tnCsh.lc./6/bw.//m +



 +1  upvote downvote
submitted by ls3076(92)
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nac nnoaey xipneal ywh (D) aealitamsp is ?oteinccrr

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angelaq11  eeuabsc miplaaseta wlodu be a asfnrrniooatmt fo het lnoram rtercutheiac of the rtsiyroraep elptuhmiie to noe htat sode not lonbge eet,rh ni rsepeons to nchciro i.rtrniaoti ihsT onwma adh pccnelmoaouc oipnanemu tath swa ryoctrlec adn( I rdea asy mo)pptylr etertd,a so seh euefrsdf na catue htrear ntha a crniohc tuin.sl +
blueberrymuffinbabey  cbeeusa aslatapime 'nsti hwo het rmnola eghoertga/nnianlriee pneroess epnhaps ni teh iavle.lo het ytpe 2 ptoemeusync vrees sa stem sl/crrleoscuspre ot btho tepy 1 dna 2 myestcneupo os teh naieeerntogr si ont .aamsaelitp +1



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