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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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submitted by โˆ—tinydoc(276)
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pg32  ecPidk D teepdsi suarnndgneitd the vaoeb ^^ uabesce L-I1 si also nnkwo sa atsctosleo titivanicga ra.f.o.ct +8
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caitlyncloy  anc aonnye exainlp wyh iths teh neawrs is AR"PC"REIAN t?siumtlnoai? I lreu uot eth rctocre swarne eauesbc i asw tcniigupr KNAR and ARKN L igd,nbni wichh is ton ?!apairnecr +1
caitlyncloy  oh.. ti msee NAKR L si dereestc to ticaetva eht .ssta.lc i wsa tcuiprgin it sa ANKRL asw no hte recsfua fo eht bsatl. eefr:e renc /veIw/=caubhJhwpyot.eu:.?ehswwtRoAsmtBcO/tt +1
makingstrides  fI oyu ca,n I odlWu glhyih decneromm gioknlo ta the hysetkc rhpma fro hit.s tI xlaspeni shit wll,e ni ym io,inonp and teydleiifn eedlph .me +
jatsyuk38  onaGjl I vl'codeu nswor dsai HPT sluetmasit olsebtoatss ot esretec LI-1 ot iettvaac ts.costlsaeo eH olsa sdai ertsnego pnvterse rssoooosietp by inihbignti elboosatts aleseer of w.Leo-Ireh..1v eterh si osla a UWlodr qsioteun weehr ti adis RKLN-A lyaps a oemr ptiotarnm lreo orcat e(rov L1I-) ni THP itmedaed eobn kbroadwen +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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