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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  iPekcd D peidtes gardesiudtnnn hte aoevb ^^ aesuecb 1IL- is alos nnkwo as stslocotae tiaanvigict to.cr..fa +8
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caitlyncloy  anc ennoay nlxaipe wyh stih eth ersnaw is AER""CRPIAN anotisi?umt?l I rleu uot het crterco nswrae aucbsee i was printcgiu RNKA dan ARNK L igd,bnni chiwh si tno aicerpan!r? +1
caitlyncloy  .o.h it smee RKNA L si etcedser to eaiavctt eht atsl..sc i aws tpnicuirg ti sa RAKNL swa no eth facuers of eth l.tbsa c:eerfneer IyechosoA?Bhepwa:/e/sOmh.vRwtut/Jb=twtt.uwc +1
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jatsyuk38  aGnojl I 'lecdvou nrwos isad PHT mulissteat olsossttabe ot reseetc L-I1 ot tatvacie eso.clstsaot He laos idas etreogsn venestpr eisoossoptor yb inbtgiinhi oaltbsstoe seerlea fo 1Ivhe.-Lwer.o. erhte si sola a UloWrd ioqnsetu rehwe it dasi RA-KNL lspay a omre pritmaont reol octar veor( )IL1- in PTH tdmadeei oben wradbokne +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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