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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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epophrysdmrtiiraayH saignuc nbeo oeilnss is iav tsoOaetslsb ngeniscair AKRN L- nspseorexi ot dbni to ARKN no etctslsaoOs dna utainislmgt them t;-&g-- nci Boen ioreosRptn

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pg32  idckPe D ietspde ndnndtagsruei eht evbao ^^ scuaebe -1IL si losa noknw sa oeltcsaost gitainivtac .af.ro.ct +8
plzhelp123  ^ I idd hte aes,m tbu it aasprpe thta IL-1 aistevcta tseotasocsl in lemlupit malmo.ye hhWic meska esesn sa ahtt si a aeslpnom fo eimumn lescl hiwch anc oudcerp rl.seunkeiint +
caitlyncloy  nca aoenyn nplxeia hyw thsi the swaren is R""PEICARAN oanuml??ittsi I leur tou eht torccer rsawen uaecesb i was tncgiupri NARK dan KNAR L niigd,bn hwich si nto i!pce?ranra +1
caitlyncloy  .oh. ti esem AKNR L si reesecdt ot atcaveti teh la.ct.ss i wsa ncputiigr ti as NAKRL aws on teh frcsuea fo hte tsab.l c:eefnee rr etouItcAm.eRovO:ewtwtu/ha?J=hyBwhpst/.bw/sc +1
makingstrides  If uoy cna, I uWlod giylhh erndmmeoc nogilok at teh cthkeys prmha ofr hti.s tI nalixspe hsit ,ewll ni my nn,iiopo adn iediflneyt deehlp m.e +
jatsyuk38  nlGaoj I 'ducoelv orswn sadi PHT mlttsesaiu stbtsoolaes to ceteres I1-L ot acatevit sseolo.ttcsa eH asol dsia rostegne netevprs soposootsier yb bignihinti aesoblotst laersee of L.eh.oeIvw-1.r htere si salo a UordWl sieqtonu ewerh it asid LAKRN- asylp a more ntomtrpia eorl aoctr v(oer 1-)LI ni HTP emteidad noeb dweaonrkb +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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