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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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prpiyairesyoamtrHhd augsnci beon lsenios is avi Oltabesstos iigarcnsne ARNK -L niersxsoep ot ibdn ot ANRK no tltsesscaoO nad umsltaintgi mthe --;&-tg nci eoBn sRtnrooipe

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pg32  kdPiec D eistepd esuiagtnrnddn het above ^^ bescaeu 1-LI is aosl oknwn sa otssacleto iiaatntvigc ..toacr.f +8
plzhelp123  ^ I idd het a,esm ubt it pesapar atht 1LI- taesviatc setlatssooc in mutlpile lom.amye chhWi maeks sense as htat is a npseolam fo uemimn lcsel hiwch anc deuocpr ielr.uinnskte +
caitlyncloy  cna anenyo paxleni why htis the wsrena si NIPA"E"RARC siutti?loam?n I relu otu eht rcoretc warnes bceasue i swa ugciiptnr ANKR adn RKNA L g,bdnnii hchwi is ton pnr?eraica! +1
caitlyncloy  o..h it seem NRAK L is csedeter ot aectvita teh s.l.tcsa i asw pciuitnrg ti sa ANKRL was on the urseacf of hte lsbta. een ferecr: IwuRAosytwo/B.u/wccO:wepteshab.t=/tvmteh?Jh +1
makingstrides  fI uyo ,acn I ouldW hiyhlg mcdeeomnr ooiklng at teh scktehy prmha ofr thi.s tI ipaxlnse htis ,lelw ni my nooini,p dna efdytinlei peeldh me. +
jatsyuk38  anjlGo I uvd'eclo rnows asdi HPT lteitausms stastolebos to ecetrse -LI1 ot ecativat .lsesaoctsot eH slao sadi etngosre nesretpv espotoorssoi by nthginiibi boeottlsas easeelr of L..whev-.e1roI rehet is oasl a UWdlro enqusito wereh ti asdi N-KARL slpya a ermo apirtnmto orel ctrao oev(r -L1I) in HPT etedadmi beno nrbwdoake +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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