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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  dkciPe D epitesd stndinarugend eht vbeoa ^^ baecesu LI-1 is olsa nnwko as ltotcaesso tagtiiinavc to..cfar. +8
plzhelp123  ^ I ddi het ,emas tbu ti raepsap taht -1IL iavascett astlstoceos in muplielt y.maloem Wchhi asmek essen as htta si a pmaolesn fo minmue llcse hcwih cna duocpre letennrik.uis +
caitlyncloy  anc nynoae xeiapnl hwy hsti the wrneas is I"RANE"PARC tmlna?i?tsiou I relu uot het eccrort weansr bseaecu i swa prnutigic ANRK adn RANK L n,gdnbii hwich is tno ac!rra?enip +1
caitlyncloy  h.o. ti smee AKRN L si rdeeestc to vectaiat the .tsas.cl i asw nrpgitcui ti as RKLNA asw on teh rasefuc fo het la.bst f eceerre:n st//?o=pwOawtBeJ.eAhewvuc/.uttmIRwc:hhoysbt +1
makingstrides  fI you nca, I lWodu hlyigh romemdnce knloiog at teh tyksceh rmhpa orf .htsi It sxilnaep itsh l,ewl in my noniiop, and iyeitflnde lehped .me +
jatsyuk38  Gajonl I 'eolcuvd wsorn aids HPT sttsmiealu steosbaslot ot ceeerts -1IL ot ivatatec ss.attsoleco eH slao sdai ernogset prtvnese pooirsstoose by tininhgiib solastoteb lreesea fo e...1Ir-vLeohw ether is lsoa a oldWrU toeqinus werhe it asdi ANLK-R slapy a erom atrpminot relo toacr (eorv -)1LI in THP aiededtm enob eoadwbkrn +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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