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Retired NBME 22 Answers

nbme22/Block 4/Question#47 (reveal difficulty score)
A 56-year-old woman comes to the physician ...
Maintenance of basement membrane integrity 🔍 / 📺 / 🌳 / 📖
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 +14  upvote downvote
submitted by bubbles(79)
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Banemtes rnaebmem rytngeiti si hte ateetrmidnn of llfu nlug eycevrro ogflloiwn uamlnropy nt.usil

ruammy:S

)(1 ossl of benemats enmmeabr iytegnirt is ricictal in ndtmneriegi het nio“tp fo no eut”,rnr nda toruibestnc to the tlbyiinai to hrabseletis onlrma gnul ruetatheiccr iwth ioooprnmt of b;ossfrii

()2 lsso fo lhlepitaie ,cslel htdnellaoie ecl,ls dan tsbmenea eembranm tynitegir in ulaus ratiliistten aonpmeinu dsoctiasae thwi ciaohpidti yapolnrum bfissori eslda to eddoysert gnul trhccreuteai nda epraupelt ;sfisribo

)3( angimoftrsrn rohwgt fotβc-ra si cee,nassyr but not eytrlien nfsiift,uce ot mrtpeoo rmpntaeen s;birfois

)(4 srtteipnse /inijniart/aturyintgren is ccriltai orf het protganiopa of isi;forsb

)5( iacipidoth yanpulrom iorifssb is an xemaepl of a espsocr reldeat ot teh tcprseeseni fo na is”,t)“e(nnag cchinro ifmmnno,ltaai adn ;srfbosii dna

6)( uneiuq cesll rea ciitralc celarull yaeprsl ni het nroigutale fo f.osbirsi

tncati:oi t/l2nP/:.ig.ricnhn.s6wlv/mce/MpmtC.2aws41pbihcwo4t/5/

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kernicterusthefrog  elLvyo +
endochondral1  yna AF ro oamptha ro rwludo octrelano?ir +
endochondral1  or swa sith a ?nadomr +
taediggity  pTey II uotpmecnsey veres sa eth tmes elcl susrrce,pro w/uto theos 'eyrou rmoe or lses cefk:du AF 2002 pg 661 +4

Quoting Dr Sattar, if an injury or cut is too deep so as the regenerative/stem cells are removed/damaged - then healing can only occur by repair. Thus, in this case, the stem cells of the lung aka Type 2 pneumocytes reside in the basement membrane - so, injury to basement membrane would damage type 2 pneumocytes and would NOT allow restoration of normal lung architecture. That's why maintenance of basement membrane integrity is the most important determining factor to distinguish whether tissue will heal by regeneration (restore normal architecture) or repair (fibrosis/scarring). Same concept can be applied to skin (basal cells) and intestines (crypt cells).



 +11  upvote downvote
submitted by drdoom(1206)
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You evha to knhit aobtu ti itsh aw:y eth menebtsa nrmbamee is teh sfnlc”d“goafi no whihc e[rstta]ivero ianlehg su.rocc S,o ey,s esmt llces (peyt II )nutscpomeye ldwuo eb vvoeindl ni ahtt anlgihe csspreo tub ythe c’uolntd erstore eht mlnoar eacricuretht o“(n mrnbas”laoiei)t wthiout het eoks’‘elnt of teh anbstmee bmeaenrm lngetil hmte rhewe ot ,og in hwta drtncoiei ot wog,r whcih ayw si ,”u“p t.ce fI eth ntebasem nebamrme si rdoteeyds, uoy acn iltsl teg hagnei,l ubt it owtn’ be aznegordi hialegn -- li’tl be dndiogaezrsi nglaieh, ihcwh esdo nto apraep sa mnolar se.suit Deoi(inzgasrd hgainel si rtebte nhta no egh,nlai btu itotuhw a ,MB het ggeantreirne slelc ntd’o heav any ic”riedtn“o nad eofhtreer n’cat etrsreo het onmrla ueitthrc).eacr

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drdoom  yb eav"tsrotier" i anem lenghia ihchw rsteseor hte ivsropue d(na lnao)mr uessit utc.iterrehac for atth ot app,enh yuo eend na acttin tmebsaen m!abeernm +2
nwinkelmann  se,Y this a gerat ymsumar to the ostp by b@beslbu nad teh eilartc eh ot!epds oenrtAh wya ot inhkt of eht siqeutno is t,no whta casesu ,rpeair but hwat cesusa evlrisrierbe y.ssiniirfobru/j aTht atcrlei neidlaxep an exitrenmep tath sodewh eatTG-Fb swa asceynser ot itiienat bsso,fiir btu if MB aws cintta and TtGFeba- aws ,oemevdr teh iroisbfs dnit'd ssirtpe, .ei. tcatni BM is riepvetcot atnagis Ge-aTb.tF hnmbtlC5Mc.:t/trgPp./e4n/o/lc16awic2.sp.h4v/wm2iwin/s +1



 +1  upvote downvote
submitted by shaydawn88(8)
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I ldwou itnhk irstleouon nsoevliv teh etsm lecsl y(ept II ue.)csepnmyto sI the citant mnaeesbt abermnme teh sanrew useacbe it mstili ?dprase

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aesalmon  I lowdu soal keil ot nkwo fi onayne nac swnera tish euosqnit - I aws it sa a rtaSta eno" da,y eno e,ekw eno noh"mt kdin of ueqtsino. Ist ryapbolb eyrv plsmei but I tisll ntod' tge ti +
bubbles  I odetsp a new monetcm lgnx:pieian nemesbat emnaermb ntiigtrey is het sgtsnotre dmitartenen fo lful xf ryreoecv oloilfnwg ypolumarn ntuils :) +5
drdoom  Yuo haev to kinth uoabt it this ayw: eth bnatsmee enearbmm si hte gcilfn“”odafs no hhwic ertat[esrovi] ainhgle .occsur ,So ,yes smte llsec (etpy II pmecus)otnye lwduo be lvoiednv in tath hinegla scerspo btu teyh ’nocudlt trseoer het oa**lnmr ietcrceauhtr (no“ mibeltnr”i)aoas thuoitw eth okls‘’tnee fo het asnetmeb eebnmmra nleglti htme hwree to go, ni whta oiirdcten to orgw, hwihc way is pu”“, .tec fI eht amnstbee mnebemar is eetrd,ysod you acn sitll teg galenh,i tbu ti wtno’ eb greozdina neghlai -- tlli’ be dnr*sae*igidoz ,elnihga hhwci odse otn prpaae sa rlnoma teissu. (saDirgodienz ahlngie si etretb ahnt on gnaeli,h ubt thtwiuo a MB, het gegertrnaeni slecl odt’n aveh any i“”irotecnd nad oteerrfeh tcna’ rsoeret eth moarln erce)rth.actiu +9
nwinkelmann  seY, tish a tager mamruys to eth psto by bls@bbue adn teh itlacer eh !posetd rohentA yaw to htikn of het nsoitque is o,nt whta aussec epirar, btu whta seaucs rilverirebes yjiuis/fr.nsbiro htaT eilrtca lxeienpad an xnmitrepee atht sowdeh -GatbeFT saw nsrescyea ot iieitnat bisfiosr, tub if BM aws inttac dan t-FbGTea was r,omeevd the fobrssii tdni'd s,pestir .ei. iatntc MB si vrotcetepi sgatina -.aGtTFbe /co/lp.bvC.t/wwtg2nhn2si6:tPcp41n//M/mhrw.cml4.iies5a +



 +1  upvote downvote
submitted by ls3076(92)
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nca ayenon ixealpn wyh D() iaptaemlas is ?nrctoiecr

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angelaq11  bseceau amaapliset wdlou eb a mnnrtoiaafstro of the loramn hietaurctrce fo teh rryeprtaios utepiimehl ot neo ttha sedo ton nlegob tereh, ni sorpseen ot hirccno roiatiitn.r Tish womna adh ccemuoaocnpl inoepmnau taht wsa crcrloety a(nd I adre yas orptp)yml aerd,tte so hse eseduffr an euatc rahert htna a cohrcin nisl.ut +
blueberrymuffinbabey  ucseabe iaeapltsma 'tnsi ohw hte almorn lgrgetahaenin/orieen epersons sphpaen ni eth eial.lov eth ytpe 2 enyptcesmuo reesv sa mest slrc/usceporersl ot bhot ytep 1 nad 2 eecyutnspmo os teh grenreoeanti si ton siam.elpata +1



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