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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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pyaritaprsHredmhoiy giunasc oebn ilnsseo si via atbseoOsslt ennicigsra RANK L- xniesoersp to ibdn ot ARNK on Osolasetcst dna liutgasnitm ehtm t-g;--& icn enBo Rpoiotnesr

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pg32  cPkied D edptsei nerandutgnids the bovae ^^ cebusae I1-L is sola owknn as asocseltot iaigtcitnva t.ra.foc. +8
plzhelp123  ^ I idd teh sam,e btu ti apaspre atth I-L1 eiattvsca tecssoalots ni umpeltli .oymeaml ichhW esmak esnes sa atht si a naopemls of enmmiu cllse ihcwh cna odercup tuleninirske. +
caitlyncloy  nac oynena enxplia hwy sthi hte rwsaen si CPERNAA""RI ?litsntiam?ou I luer otu teh ccroert reansw uaecesb i aws upcgtniri ANKR dna ANRK L ibndn,gi whcih is nto n!earp?rica +1
caitlyncloy  .oh. it esem NKAR L si ctsredee ot acitveat the ctl.ass. i was iucnrtgpi ti sa LKARN asw on eht usercaf fo het .ltsba crfre n:eee /hec./Reho?t/tspwwJetwaO=bthAmo.Itwyvsu:cuB +1
makingstrides  If you nac, I uloWd liyghh ndormmece nloiogk at eht cyheskt mrhap rfo ts.hi It aiepnxls iths l,ewl in ym io,oninp adn ifiytdnele ephedl e.m +
jatsyuk38  alnGjo I ueclo'dv rnwso iasd PHT sslueamitt osselobtats to treesec -IL1 ot taceavti otosse.atscl eH slao idsa egtnsero revnstpe soospoeisrto by igihibtnin olbtsatsoe saelree of hLw.eoe..-1rIv eehrt si losa a UdolrW oqitsune ewehr it dsia KALRN- lsayp a more imtotranp lero trcoa (veor IL-1) in PTH atdeimed enob rebwndako +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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