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Retired NBME 21 Answers

nbme21/Block 4/Question#31 (reveal difficulty score)
A 48-year-old woman comes to the physician ...
Paracrine stimulation of osteoclasts by osteoblasts ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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yiyrhesmatHidoarppr ciusnga beno elssoni si aiv tbsOsatlose iaseirnngc AKNR -L esroxisnep to dbni to ANRK on ssstetlOaco nad sailnmttuig mhte t&---;g cin oneB ptrooensRi

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pg32  icedkP D pdseite iedngsaurtdnn the vbeoa ^^ auebcse -L1I is laso nnwko as teooalstsc civtiangtia .faroc..t +8
plzhelp123  ^ I did the s,mea tub ti arepasp thta L-I1 tiasatvec ossascetolt in pltiueml mayeom.l Wihhc meksa essen sa htta is a pesmoanl fo neiumm cllse chwih cna pdreuco ik.ilrsenuten +
caitlyncloy  can nyenao ipealnx ywh this eht ensarw is PREIA"CN"AR ?oinm?sittula I rlue uot hte orcecrt ewnrsa ecseabu i swa nigucpirt RAKN dan KANR L ,iginnbd hwchi is nto rara?nie!cp +1
caitlyncloy  .ho. ti esme ARKN L is cdretees to eaivttca hte ssc.tl.a i was igcuntrpi it sa KNLRA aws on hte eurafsc of het asb.tl eerener:cf /twywhBwb?.:cwoatRAteots/c.sOtJhheuI/mevp=u +1
makingstrides  If ouy c,an I dlouW hhlgiy mrmdecoen lgkooin at het hcykset aprhm rfo s.tih It islpenxa this ,llwe ni ym noo,npii and idtlnieyef hepdle .me +
jatsyuk38  Gjolan I uodl'ecv rwnso isda PHT tissleautm soalbtsteso ot eseretc -1LI ot evttciaa atcslstos.oe eH osal sdia oesegtnr rnsetvep oosoprsietso by nhnitgiiib etoblossat erleeas fo -Lvhew.r1.eoI. etreh is aols a oWrdlU ueisonqt herwe ti dais NR-LAK lasyp a mero tarpnomit roel rotac ore(v )-1LI ni TPH metdadei bneo rnoebwadk +1

Primary hyperparathyroidism: overproduction of PTH by parathyroid chief cells Effect of PTH on bone โ†’ increased bone resorption โ†’ โ†‘ release of calcium phosphate โ†’ โ†‘ calcium levels Induces RANKL expression in osteoblasts โ†’ binding of RANKL to RANK on osteoclasts โ†’ activation of osteoclasts Induces IL-1 expression in osteoblasts โ†’ activation of osteoclasts" Amboss

Not sure why D is wrong

+/- alexv0815(10)

Primary hyperparathyroidism: overproduction of PTH by parathyroid chief cells Effect of PTH on bone โ†’ increased bone resorption โ†’ โ†‘ release of calcium phosphate โ†’ โ†‘ calcium levels

Induces RANKL expression in osteoblasts โ†’ binding of RANKL to RANK on osteoclasts โ†’ activation of osteoclasts

Induces IL-1 expression in osteoblasts โ†’ activation of osteoclasts

Not sure why D is wrong

+6/- alexv0815(10)


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