Kim! Hi! It’s your dad!👋 ▪ Khalilah, I’m proud of you for taking a risk for your dream.Everyone’s explanations tend to be so on-point, and the commiseration makes me feel better, too!Hi Hira. You are doing a good job!Hey Shariq! Doing a great job!                       want to add a fly-by? email us! 😊
share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
search for anything NEW!score predictor (“predict me!”) NEW!
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:

Login to comment/vote.


Tutor box

Members from the Leaderboard offering 1-on-1 help: Want to be listed here? Email us!

 +10 
submitted by cafeaulait(10),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

I ivlebee htsi estm yam eb rergfniin NME 1 donyrems - pisesblo anamgstior teipcp( ceulr ediaess d,x) ydhoriptraa eod,nama adn iiutaytrp oemnaad ag(uicns ).IAHDS uBt, uyo 'ntod dnee to neve ownk tish to etg isht rhgti - jtus gniask eth tefcfe of hhgi THP on eht eysmst - ussace iredcnsae ssacltotoe itiacvyt sa wlle sa antm.tiauro

fatboyslim  The symptoms of this patient are due to hypercalcemia (stones, bones, groans, THRONES [increased diuresis}, and psychiatric overtones). Hypercalcemia can also cause peptic ulcer disease. So the primary pathology is parathyroid adenoma/hyperplasia causing the hypercalcemia +4  
beetbox  Does anyone know what's up with the 'no abnormalities in humerus Xray'?Did they just throw that in for no reason? I got hooked on it, I thought there was no increased osteoclast activity... otherwise the cortical bones would have been oddly thin or something +1  
topgunber  MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question. pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones. Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma) Question is actually asking: what are the effects of PTH? a, c, opposite of PTH D and E i believed aren't related to PTH B-Sounds something like the pathogenesis of pseudohyperparathyoidism F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer. +2  



 +3 
submitted by laminin(16),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

can omeosen naixelp ywh it ysas eh ash na nt'cti'a PHT .cttnn.aoi.enicsor it ot lte us nwko taht teh HTP eoanccttnrnoi si a leutsr fo pyhloaota? dgn shtw'a sih dx? h!nkats

yotsubato  I swear they make up some of this stuff. Like whats up with the thirst, urination, and peptic ulcer diseases. +8  
redvelvet  hypercalcemia can cause nephrogenic diabetes inspidus; so thirst, urination. hypercalcemia can also cause peptic ulcer disease. His symptoms are all about hypercalcemia due to hyperparathyroidism. +3  
namira  "Hypercalcemia can cause renal dysfunction such as nephrogenic diabetes insipidus (NDI), but the mechanisms underlying hypercalcemia-induced NDI are not well understood." https://www.kidney-international.org/article/S0085-2538(16)30704-9/fulltext +1  
dulxy071  Why can't the correct answer be C) which points towards renal failure, which may lead to secondary hyperparathyroidism having the same results I believe +1  
pmofmalasia  The secondary hyperparathyroidism in renal failure is due to loss of calcium in the non-functioning kidney. In this question the calcium was elevated, so you can rule out renal failure. +  
sars  Hyper-calcemia causes stones (calcium stones), groans (constipation), thrones (increased urination), bones (increased osteoclast activation), and psychiatric overtones (depression). +  



 +2 
submitted by killme(14),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

The pntccoe iebng dtseet is wa"ht seod HPT od tath sleda to phcymracle"aei gjhV/Pm/e.3osa.pi.itbt:Kngpsic/b/d

yotsubato  ugh, bullshit. I was trying to figure out an actual disease process here. +6  
rio19111  its primary hyperparathyroidism caused by parathyroid adenoma. addition of the peptic ulcer suggest Zollinger ---> MEN1 but none of that is imp because that's not what they are asking. All they are asking for is the function of PTH. +2  
topgunber  MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question. pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones. Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma) Question is actually asking: what are the effects of PTH? a, c, opposite of PTH D and E i believed aren't related to PTH B-Sounds something like the pathogenesis of pseudohyperparathyoidism F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer. +  



 +2 
submitted by sympathetikey(1461),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

nI ddtnoiai ot PTH = aolstsecto citytaiv = ieecdsanr mcuc,ail siht spnero olduc oasl be ntbixgiieh pytmmoss of E.MN1

topgunber  MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question. pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones. Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma) Question is actually asking: what are the effects of PTH? a, c, opposite of PTH D and E i believed aren't related to PTH B-Sounds something like the pathogenesis of pseudohyperparathyoidism F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer. +  



 +1 
submitted by rio19111(14),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

tsi ryipamr yisiaprmhdapeyrrtoh edcsua yb ortadhyraip na.oemda iitdadno of eth icptep rlceu etsusgg nolliZger tg-;-&- M1EN

but noen of ahtt is pim csabeue 'attsh not htwa tyhe ear igska.n lAl heyt era kngsia rof si hte unfnioct of PH.T

rio19111  Stones, groans, thrones, psychiatric overtones ---> symptoms +  
topgunber  MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question. pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones. Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma) Question is actually asking: what are the effects of PTH? a, c, opposite of PTH D and E i believed aren't related to PTH B-Sounds something like the pathogenesis of pseudohyperparathyoidism F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer. +  



 +0 
submitted by nwinkelmann(321),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

soeD yaoenn wnko eth icsiicngneaf of oocyemtn i?tlytimo




 +0 
submitted by arthur_albuquerque(1),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

tWha pdeleh em ot ranwes iths oen etiuq eisayl wsa teh fnwoolgil elrnati:oa

leayirapmeHcc + hgih PTH ;&g-t p"irmyar ihyrradeoy"ipatmprhs

woH od hhig HPT dlea ot laiper?ycemach gcaIninser tscastloeo !tcaiyvti




 +0 
submitted by topgunber(47),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

NEM 1 - P P P . Pydta,raohir ts(prernacasgnia ni tsih ce,a)s ripatuyit .esnoil not yke ot gnrasinwe hsti tusnoeq.i

pt comes htwi psytomms fo clreaciy,phmae moans, ,gsonra othenrs ei(,)gpne ypchs eso.veotnr

kooL ta thp adn .miccalu ew ees ighh ac dan hhgi .htp eW wnok htat ihhg cmcaiul owudl wlroe hih.tp..st nmsae eth ihhg maicluc wsa deu to the ihgh pht ie(.. hrradoaptiy aoamd)en

snQtoeui is latcaluy is:kgna thwa era hte effetsc fo TP?H a, ,c tospioep of TPH

D nad E i ivlbeede nr'aet aeldert ot HPT

BuS-dsno smhngitoe kiel hte ghseaptneois fo saeyueypdrrtoshphapdomii

F- we efidlytien know that PHT ensacirse aC , so yb nnsaegriic oetoclstsa itruv/ityatcioamnat you tlreeabi iumlcca iotn eth bl.doo hsit is het tbes re.snwa