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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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iorysrhydeaHpmprati uagnisc beon eiosnls si iav eOslbtstsoa rignnseaci RNKA L- riosexespn ot dbni to ANKR on aoltetsOscs nda miitaltnugs hemt &--t;-g cin nBeo itopoesrRn

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pg32  Pckedi D pesedti ddaenntgisrun eth vobae ^^ scbeuea LI1- si salo nkown as tleosoastc gitivanicta .r.ocfa.t +8
plzhelp123  ^ I did hte same, btu ti psrpeaa ttah LI1- tceatisva otcelssatso in mipelult ymmaloe. ihcWh esmka nsese as hatt si a nmeolsap of emunmi lscle chwhi cna rdocupe elrk.inesnitu +
caitlyncloy  can eoynna ilaepxn ywh stih het sernaw is NEIR"C"PARA oan?limtsiu?t I rule out het etrcrco wrasne ebecasu i asw gtiiprunc KANR adn ANKR L dii,ngnb ihwch is otn ?!irpneacar +1
caitlyncloy  .ho. ti emes RNKA L is eretdesc to tiavcaet eth sca.stl. i was cgipurint ti sa ANKRL asw no hte sfreacu of hte .sblta en efrcer:e ?eoAOIhcuweb/hy/c=:t.thpw.tsBtwatmew/sJuoRv +1
makingstrides  fI ouy c,an I ldWou ihhylg emeorcdmn onkoigl at the yschtke rmhap orf ht.si tI lsiaxenp shit ,wlle ni my oo,inpni dan yefitnldei peheld me. +
jatsyuk38  Glonja I duvlceo' nwors dias PHT iastustmel lsstbsoaeot to ecetsre IL1- to tevactai sate.slcoots eH oals disa goseertn epsrevtn espsooirosto by biiihgtnni ssatotlebo esalere of .o.wLreI.h-e1v erhet si lsoa a WldUro nqusitoe rwhee ti isda AKRN-L lyspa a eomr rtiotnmap rloe caort o(evr -)1IL in THP ieadmedt boen wenodakrb +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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