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Retired NBME 21 Answers

nbme21/Block 3/Question#28 (reveal difficulty score)
A 1-year-old girl is admitted to the hospital ...
Disruption of the secondary structure of collagen molecules 🔍 / 📺 / 🌳 / 📖
tags: biochem

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submitted by wasabilateral(47)
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I inkht ti sha sogimhetn to od wthi geynlci u(de ot tsi llsma zies ti nca tif in ymna plseac hwree herot naoim sadci can ont dan chnee ti svpriedo “arcututlrs ”oestscnpmac to eth clo,aegln ..ie utp a nikk ni eht aahlp xlh.e)i fI ngylice si desclpmia yb imnhgeost sel,e I nodt’ inkth nolerlcgapo- anc mrof ist rortcce cdyorneas teurtr.csu

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jotajota94  eT!ru ,osal nyliecg is /13 fo alegolcn aafl inh,sca os ti makse eness htta soubinttutsi twih anelina icwhh( si humc grebig) woldu laed to tdnruiopis in eth halpa xihel nmt.arifoo +2
jotajota94  Teur! l,aso iyncgel si 3/1 fo gcnlleoa lfaa ,hcisan os ti kmaes snese htta oustisubtnit itwh nlaenia (hwchi is hcum )grbgei dulwo aedl ot inpirtodsu in eht paalh lhxie .tnoiafmor +
thepacksurvives  leinyGc is asmll dan y,dbne hciwh olaslw it ot form the rsbilfi orf hte iprelt lhexi +
brasel  Asol in reeglna (AF 0812 gp 50) IO is ormf brpmoesl orgimfn eht erptil lxhei ichhw is sderncayo uetrtc.rsu Froa,utylten tyeh aveg us ngetmohis ot raosen hwti ni hte oieuqnst &(al;)-tyGlgA +3
amy  naC noemose ephl me rnddsentau yhw A si rrcno?ecit F020A2 eagp 5:0 liTrep eilxh fo 3 ogaencll a snihac si deofmr rofm ronlecopalg iav edhrgoyn dna disudleif b.don sI tshi yvre riiaslm to wtah A is Adn?rcg e.iib Desearecd dnrob-eynodhg imoonfrta etewben oneallcg elleocsm.u +
umpalumpa  hTe ixnneaapotl ngvei by ibtserawallaa cdoul krow if eht uqoniest dlouw say lgytGa-A&;-l aiotu.nmt rHvwo,ee eht itnquose settas that tehre si an ;&GygltA-al- ami.uotnt +


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submitted by cellgamesgojan(43)
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I if,rdgue c-inXgy-elY si tyihnleaccl ndeedriosc a mp“ariry oniam icad ucustrert of a nop”rite sneic the nnofietidi of a iyraPrm uuercstrt fo a rpieont is a“ lianre nhcia fo iaomn s”ai.dc fI you emss whti hte aPmiryr cttsre,uru sa ni the iunsteqo ts,me yuo otnnca from the adeynScro sceutrtur of eht ot,irnpe hhwci is meddtneeri by the ro-dnngdgieohnby wihhc rcousc ebenwet teh eidppte anbkoecb, tpnnniedeed fo eht R rpu.sog I epho itsh dame seesn.

rFmo kipiiwdae: acenoS“ryd sueurrctt si alomyfrl eenfidd yb hte aptretn of rynhoged donsb ntbweee hte noima endhgryo adn bycxorla xgneoy atosm in eth eptpdie aobkbenc”. eia(mphss i)mne

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From Molecular Biology of the Cell:

Biologists distinguish four levels of organization in the structure of a protein. The amino acid sequence is known as the primary structure of the protein. Stretches of polypeptide chain that form α helices and β sheets constitute the protein’s secondary structure. The full three-dimensional organization of a polypeptide chain is sometimes referred to as the protein’s tertiary structure, and if a particular protein molecule is formed as a complex of more than one polypeptide chain, the complete structure is designated as the quaternary structure.

https://www.ncbi.nlm.nih.gov/books/NBK26830/#A406

+5/- drdoom(1206)

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submitted by usmle11a(102)
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ko sugy dna i etuoq rmfo ofiet.miestttr.1co/asesmp/oc4/lbw/upneit2e-othdwelwahg/pss:rocrie0st

09%" heva na diafebilntei ecientg ioatmutn LCO 11A dan CLO A12
s aceus lbnmaroa caongell slricnon-ksig via a cneygli uisttinsobut ni het oollcergnpa luclmeoe "

hhcwi saenm ahtt OI ash a elygcin sutitinobstu dna efoerrth its anelbu to mfor a saeocyndr utrctu.erus

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submitted by hungrybox(1277)
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Deu ot slneyigc' mlasl szie, ti saeecrt kk"sin" ni hte oainm diac uenceq.se heesT kniks era eended ot cotrleyrc fmro eht odesnrcya trsteruc.u

eOhrt erw:ssan

  • ea"dekwen anetctnoiri ebtenwe oglleacn adn conyaglt"epor - lganleco + gcaoepnoytrl = ag.teciarll eTh outnesqi esmt niosnmet ynma tfesdce ni NbEO te(yp I eglalc)no but on nnioemt of fsetced in rWclaeaTglO t(ype II egacllno)
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 +1  upvote downvote
submitted by basic_pathology(25)
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YGl--yX is ncebobak orf lncegalo aphla .cainh 3 llecagno pahla cahnsi ilsapr ot frmo iltrep ixlh.e elGcniy ash on R ogpr,u ngawolil fro fetbylixlii nda tornfoiam fo peiltr lh.eix oN ycielng erspvnet hist utoosnicun rgli,psnia tvrngeenpi het mfiartoon fo loecnlga dyrnaesco c.rrteutsu

ecalRl taht ci-lhsepleaha nda stb-taehees aer exlmeaps fo dronysace erucst.trsu Tsih anc be hgtotuh fo a tnisotinaamfe of eth aahlp li.hxe

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submitted by an_improved_me(91)
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rAtehoN yaw ot get ta ti is iva ntle:inmoiia

.A dernyhgo dongbni udnwlto ralley hngeca cesin ihtneer nialane nro lyngcei era o lp.arB yGl &g;t lAa hl'snutdo haceng how pirenol is mfiieodd I( aemn it ,OLCUD if htree was a ritsce rhiaecdnn or ihg,entosm btu otn a trgea aswD)ne.r gotnhni ot dcitinae htat aglonlce aeoinrgdted si dleetar ni presoens to na AA toist.nubisut Ao,ls in het txotnce fo OI h(ihcw si teh etpgnserin p,ltaionm)c ew aldaery wnok that eht bprlemo stdoe'n heav yhnating ot do ihtw in,oartgedde orme tiwh het eanhgc ni sirtec.unc uEnttuorf/ lstHoyen ndo't .nowk

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submitted by drdoom(1206)
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ser’eH one awy ot sriclsmieoe-otpfne-a cd“dereeas nyd-oghrnbode ”ft:noiorma ’Im ont a igb afn of ihst elin fo noae,gsirn but cenliylhtca nileaan sa a ides oprgu sha erom negdo*srhy rof ttonalpei drnhoegy nbngido nhta icngley:

nalea:ni —H3C
:lngyiec —H

So, ”ln“ceitl,cyha inlenaa uwdlo tiempr roem hnnod-bgrdeoy oam,rtnifo wcihh hmtgi llowa yuo to neaiemlti taht cih.oce

taTh sa,id it seesm amslto oiespilbms ot rule otu it(towuh yevr cincealht gewknldoe ro mose rvipdode lpmneertexai daat) ahtt hte htillysg rrleag anienla deso tno raimip oghynrde gboindn bwneeet glalcoen csmlloeeu vai resitc (alsapt)i ernrftinece.e nI implres rems,t scine ananlie is rleag,r uyo lduwo tnkhi that it sumt hwoomes rrefeniet twhi the nndbyiogroed-hng atth rosucc thiw teh ltiwyed-p niecgly.

---
rS*ylittc ,naspegki ts’i ton the emubrn of eyrnsogdh but salo het hegtnstr fo teh odleip ttah tlsaaietfci gnydrheo nn:diobg a ndygrhoe nudob ot a lgtysorn laeceeonirtgvet ceulolem leik nlofeuri llwi “apapr”e oemr vositeip ,adn s,htu dnogonedhyb-r meor tysrlgon wiht a yernab xgoyne (ampecrdo tihw a yogehrdn tonceedcn to braonc, orf x)mpl.eea

tFhrrue raide:ng

  1. /eic/hw.dd/qgehhl.b.h:oelwnsu/mipdhetpu.swucutprtdlm/
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hungrybox  rectapApei eht fertof btu shti si raf oot ongl to be u.eusfl +30
drachenx  obxrnuyhg is a faeirngk aterh +
drdoom  rhdeacnx@ ha,ah hn,a mgoicn bcak ot isth i eaizerl i asw pobylrab r-egevknegio llo +1
blueberrymuffinbabey  ni'st eht yrodghen ingbond deptnnede no het ldxahoyertdy onelpri and l?sniye os htat udotln'w lryale eb teh eusis hree esnci theso earnt' het asa engib aterled? +
drdoom  r@eyulebbr gricAdcon to ’lAetsrb CMoB (ees Tgntaesn ta r,thig) yyoxrsdhnyiel and oyndhrielpoyxr bntutireco dngoeyhr odbns htat morf etwnbee eth nichas iat“n”,(erchni as podeosp to naarnic-;ith eht sahn,ci of o,cseru aer treaesap idpetlpoey;ps taht ,is saptreae agclnole oternp;si nad orcitnaisnte teewbne pesretaa nahsic esrp[atea tilsepe]oppyd si wtha ew lcla uryte“rqnaa uert;cts”ru ese etnganT boeva.) dnA in tish as,ec as yuo ptnio tu,o hte mset ecsbierds a A&yg-al;tGl uitisnbtost.u ahtT emsse ot aenm owt nhig:ts )(1 teh ehrte aaesrpet locgalne ppyedslotpie wlil ont cap“k a][s ihttgly” to rmfo eht pritel exlih ray(ueqan=tr )rcrustetu we all nwko nda eolv and 2() relinop igrns will flai ot eaylr qtuei as lg,nusy omrgoinpsicm het elailhc moonantircfo ttha fisdene na pahla hianc roy(e=dnsac t;rrcseuut het saehps taht rfom hitwin a snileg pyoe.idpltpe) +
tadki38097  lsao you 'tacn H odbn ihtw nr,boca ts'i ont aplor ugoneh +
amy  2200AF 0P5 a:ttse marinofot of h(glaeocwrciohpnl is the pliret ilxeh uer)ctrsut via orneyhgd adn .dulidsife So A si rceoicnrt bc eerth are no ongalelc coemllseu yte 2nd( utrrutesc enshppa ta loagclnoper )lleev +
drdoom  a@ym rlpeit xhlei is a uqatanerry rtterscuu c(seni ileprt hexil si a aesph atth msfro ETWNEEB rtaeepas ro “dautl” ancolcglo/le-reglnapo .ptpeiesd) iryraPm, rdyacosen dna trrayeti srcusteutr ear iitnocepsdsr of a ingsle tiyodlp.pepe cOen uoy avhe 2 ro ermo tyiopesldepp igntntercai thwi heac ehtro .,e(.g nomielogHb lc)umleeo yuo ehav qryuartena .uerstrtuc +

From Molecular Biology of the Cell:

Hydroxylysines and hydroxyprolines are infrequently found in other animal proteins, although hydroxyproline is abundant in some proteins in the plant cell wall. In collagen, the hydroxyl groups of these amino acids are thought to form interchain hydrogen bonds that help stabilize the triple-stranded helix. Conditions that prevent proline hydroxylation, such as a deficiency of ascorbic acid (vitamin C), have serious consequences. (Emphasis mine)

https://www.ncbi.nlm.nih.gov/books/NBK26810/#A3555

+1/- drdoom(1206)

From Molecular Biology of the Cell:

The primary feature of a typical collagen molecule is its long, stiff, triple-stranded helical structure, in which three collagen polypeptide chains, called α chains, are wound around one another in a ropelike superhelix (Figure 19-43). Collagens are extremely rich in proline and glycine, both of which are important in the formation of the triple-stranded helix. Proline, because of its ring structure, stabilizes the helical conformation in each α chain, while glycine is regularly spaced at every third residue throughout the central region of the α chain. Being the smallest amino acid (having only a hydrogen atom as a side chain), glycine allows the three helical α chains to pack tightly together to form the final collagen superhelix (see Figure 19-43).

https://www.ncbi.nlm.nih.gov/books/NBK26810/#_A3551_

+/- drdoom(1206)

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submitted by nmb29(0)
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I ihmgt eb gnehrtiokvni ti ub,t H odnb ofmtaoirn of s'aa seakm eth srenoyacd rcteustur fo teh rpetoni (lcglonea ni htis ae.sc) hTe lyG to alA iiosubtsntut eods eutslr in sles H obnd fmooriant, utb fo dlaivudini aas' ton eetewbn coagelnl eoescumll tath( tmhig eb roem ofr yrquanerat retur)ucts

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lpp06  I inthk hte kye si in eht eawrsn irgspan,h eht ernasw inmteoinng ond-bHs assy Dis"otipnur of oH-dbns etneebw elgalnoc oouthhlesuAe" lgcml anllgceo odse gruneod -Hgobndin ot psurpot the prilet xhi,el siht si oden ihnwit eth sema enlgolac e.cenLigkimluno l ffinertde enocllag sclmlouee cocrsu aiv teh esynil - reniyysyxhodl lksni enod ni teh MCE +1
kevin  shit is eth eno momncte ahtt yalflni pheeld me drdtnsaenu ywh ahtt wsa .rcrctinoe ahknt uyo +


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submitted by j123(16)
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ryirPma rursutcet = naiom icda ocecSeeyunqaenr sd ursettrcu = utrrsceut dmeorf ithw a ngelis monai cdia qecesneu bate( padltee hets,e ahlpa e,lxih caetytirTr)e eutrsrcut = tlmilepu onadrcyse suuterrtcs ignertantic eotgetrh tillpemu( tbae epdtael shstee caektds on tpo of ahce t,oehr r)ceryatta nQuer rsceturut = etrpnio rurtsectu omrdef mrfo lfdonig of lla ryittaer sturcurste ot kame biindgn ,steis .tce

Scine het laniane was tpu ni calpe fo hte iyelcn,G eht mpyarir recrutust saw aluenb ot frmo na lhaap eixhl icnse plhaa hlxei uesctturrs eedn a tpcrliuaar euescqne ylg( - -x y) ni dorre to mrof gonedryh odnbs to epek eth exlih eatsb.l

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 -1  upvote downvote
submitted by unknown001(9)
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wath si lecoanlg ? a oycdarnse otrenpi tsc.ururet

whne oyu meovre ,neicylg eth sotm atnnuadb ianom cida , mfor eth puorrcser mueeclol ilwl you etg a reorpp dnarcosey urrctutes ? ON

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unknown001  georin ihts +
drdoom  can ouy lbaetaore? tashw' gownr hitw uoyr tmm?ceno +


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submitted by lilmonkey(63)
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Gly si ,olpar enialAn is ponoanlr adn dhio.coybhrp sMissnee cornonsvntaviee taton.imu hsTee AAs have trffiende hcelcaim esroptprei hchwi laed ot ueddirstp rtnpieo lifdgno ordsnceya( sre)turt.uc mirSali to luG - laV onstbusitiut in Secikl ellC sei.Deas

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