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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  dckPie D eitesdp dnanguirnsted teh beavo ^^ sabuece -L1I is losa onnkw sa ototcsslea tgtavniciia tr..aof.c +8
plzhelp123  ^ I ddi eht saem, tbu ti aasrpep ahtt I-1L avcettisa tlscooestsa ni mluetlip yaolemm. hcWhi ekams essen sa tath si a nmaoeslp of inuemm slecl whcih can rocdpeu ntlukni.esrei +
caitlyncloy  anc eaynon xlpiane hyw tihs eht wanrse is P"IREARAN"C un?mlota?itsi I relu uto eth ecctror seawrn sbceuea i aws iugcpntri RNKA adn ANKR L idbi,nng wcihh is not reipac?na!r +1
caitlyncloy  ho.. it esem RAKN L is credseet to eivacatt hte asstcl.. i asw igunprtci ti as ALRNK asw no teh cfaurse fo hte .ablst :eeernc ref ouvoIhAhwh?twetOct:westJeBa/cw=mt./Rp.uy/sb +1
makingstrides  fI uoy can, I odlWu lhihgy nmdreemco lgoiokn at eth ecythks ahrmp rof h.its It lipseaxn tish ,lwel ni ym ,pniiono nad leiednftiy delehp em. +
jatsyuk38  Galnjo I d'vecoul nwosr asdi HPT uamttslsie lteosstsoab to eestecr -LI1 ot atactvie toslsctes.oa eH sloa dais toresneg psrevent rooesootpiss yb iinghntibi oolsetstab lsraeee fo eL.wo.hverI-1. treeh is oals a WrUdol seoniutq ewhre ti adis -LRAKN ypals a mroe otparntmi oerl tacor rev(o 1-)LI ni PHT edaitmed bneo wkodraneb +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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