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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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Beetsmna mabneerm rttingiey si teh ernmatndtie of fllu ulng cvereryo gwlilfnoo nluarymop ulni.st

mySa:umr

)1( osls of atesnbem emarmbne etigyitrn si crticial in irnmgeenitd eth nopti“ fo no ,etu”rnr dna ernsittcuob ot eth ytniablii to ieeathsrslb nmlrao nlug rructhaeteic iwht ooritpnom fo or;ifsibs

(2) ossl fo pitiaelhle lle,sc lneiotldeah lescl, and etbnmesa mernaebm gtrniitye in usula tirlaiintste nnoemauip cdtaesoais thwi dahiiitopc noralmyup siborsif ldaes ot eetsyrddo ugln attreihucecr adn eeruapptl ;osfrbisi

(3) nsrtfmironga hgtowr -ortfβac si cesaye,srn utb tno yitneerl uctsnf,feii ot etmoopr emtprenna sri;osifb

4)( inteserspt yi/iugnenia/trtarntjnir is tliracci for het gnopoptiara of ;bsfriosi

)(5 oiipiathcd mynplroau soribfsi si an xemalep fo a ssropec edlraet to eth rpssetnieec fo an gt“in(en,a”)s cirhnoc iliaanom,tfmn dan isofrb;is nad

)6( nquuie lcles rea itciacrl lrlceaul aerplys in hte egnuatiorl of sii.rbfos

atc:nitio2pt/4sp4cC2nwc/ng/i6/enwlm:irb.1h.vitwMt.m/scPh5.o/la

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kernicterusthefrog  veoLly +
endochondral1  ayn FA ro tphomaa ro wodlur ?taloienrroc +
endochondral1  or wsa shit a ?amdnro +
taediggity  eypT II oenmepytscu evrse as the esmt ecll sr,reroscup twou/ hteos re'uoy oemr ro lses dukfec: FA 2200 gp 166 +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).


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 +11  upvote downvote
submitted by drdoom(1206)
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oYu veha to thnki buato ti hist yw:a the bnesmtae maemnerb si eth ginslaff“”dco no hhwic vret[rtsa]oie hgalien srcu.oc o,S eys, tesm llesc y(etp II ecn)euyosptm wdluo eb eionvdlv in taht enlahig ossrpec btu yhte d’nultoc eserort eht omnrla utirhaecctre (no“ ebno”it)aalmsir uthwito teh k‘’oneltes fo teh btemesna bnmeaemr iltegln tehm eerwh to g,o in what ncidtiroe ot w,org hhcwi awy is “,p”u tc.e fI the neteambs bnreemam si oderytsde, you nac llsit gte igae,hln ubt it n’two be zioeangrd ieglahn -- ’illt be dnagdzsoerii ieganh,l whhci sode ont rapepa sa rlmaon .iutess gzdaesirinD(o engliha is tbeter than no hegl,ian utb uhtwiot a M,B eth argriengneet elcsl ’otdn haev nya cnre“”itdio dna feetrohre atnc’ eerstro eth rlaonm iceaeutrrhc.)t

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drdoom  by roat"vrti"ese i eamn eihganl cwhhi essorter hte srioeuvp n(da mroal)n estsiu rcehtcar.eiut ofr atht to p,nhpae uyo nede an cattni beatmens ee!rbmamn +2
nwinkelmann  eYs, htis a atrge uamsmry to the tspo by bb@ulbes dna eth rtcelai he edspot! eotnAhr ywa ot tihnk of teh uqenotis is nto, ahtw scseau r,eirpa but tahw acuses eevisrrirelb yinosisiur./bjfr That iltcrea eaidelpxn an mxieptener htta doeswh -eGabtTF wsa caryesesn to itteiain fiis,bosr tub if MB wsa cttnai nad Tb-etFaG saw oedvm,re hte ibirsfos indd't rs,tiesp ie.. ctiatn BM si teeovtcpri satanig ateb-TFG. cct/rn.i1om/i5p4wn//C2.imtnh.ssepPMthw/.c/gl26vwal4:b +1


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 +1  upvote downvote
submitted by shaydawn88(8)
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I luodw tihkn uriotnleso ioevvsln hte tesm ellcs y(tep II my.ncps)eueto Is teh tacitn tebnmsea eambmnre teh sreawn esacube ti lmtsii r?adsep

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aesalmon  I ulodw sloa ilek ot kwno fi nyanoe can nwaers htsi seiuoqnt - I aws ti sa a ataSrt "one ya,d one ,kewe one nto"hm nikd of quies.tno sIt ayboplrb yevr plesim utb I lslti dnto' gte ti +
bubbles  I dpoest a nwe cmneomt pnaii:xngle neaesbtm emabemnr ntgyrieti si teh gneotssrt tendermtani fo ulfl fx reroycve oiogwnlfl monauylrp tulnis :) +5
drdoom  Yuo haev ot nikht touab it htis aw:y teh samebnet bremnaem si teh ol“ffs”cgaind on which eiae]ortrst[v hniglae cuc.ors S,o ey,s tems ellcs y(pte II uytnee)comsp doluw be lodveivn ni thta ihangel oprcess utb tyhe ltdu’onc eetosrr teh rm*la*on eruccthitrae n(“o enalo”mtsrai)ib wiothut eth on‘e’sklet of eth snbmeaet mnmaebre lnlgiet emht weerh to ,go in twah renotidci to wg,ro ichhw awy is “pu,” .cte fI eth setmbane rmbemane is esdtoyd,re you anc iltls etg ,ignhela utb ti notw’ be rnogzdeai iahelgn -- ’itll eb iisegrond*zda* neah,gli hwhci sdeo nto aprpea sa ormlan .ssueit se(nDgirdizoa lhieagn is better ahtn no inaelhg, btu ituwhot a B,M eth regnegtraine cslel dt’on vhae yna noetciir”“d dan feertrheo tn’ac soeetrr hte lmanro iceecharu)t.tr +9
nwinkelmann  Ys,e ihst a rgate marsymu ot hte spot yb buebl@sb adn eht cteailr eh pdt!oes nethAro yaw ot nikht fo teh soeunitq si t,no ahtw casuse erpa,ri ubt twah cussae irsrveribele biniusfysrr/o.ji aTht airelct eneladxpi an nteprmeiex ahtt eoshwd FeaGbT-t aws enrsescya ot tiniteia isobf,isr btu fi BM wsa aitnct adn tebG-aFT aws od,verme eht sirsiobf dn'itd epts,ris ..ie tictan MB is otieeptcvr satnaig batFG-.Te cwt/2piwsmnv1M2/hi5./ln.4l6rnewt/gsmPbCopa4i.t.c/:c/h +


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 +1  upvote downvote
submitted by ls3076(92)
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can aynnoe npeixla hyw )(D aeapaltism is ornecictr?

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angelaq11  uabcees aaspielmat woldu be a nrafomntotarsi of het rnlmoa teutchicerra of eht restoiprrya pimilthuee ot noe ahtt esdo nto lenbgo r,htee in psrseone to ocrichn aotirirn.it hiTs oamwn ahd ouancmclocep aenopmiun taht wsa toeyrlccr d(an I dare ays oylp)pmtr eett,adr os hes rfdefseu an atuec threra hatn a ihncocr t.inuls +
blueberrymuffinbabey  eseaucb epatmislaa n'its who teh mlarno lonienrht/inagraeeeg ssnoerep pnaeshp in eth vaolli.e teh ytpe 2 ynpmcueoset ervse as tsme erlclcsopessurr/ to thob etpy 1 nda 2 seyeompnutc so eht roeigteennra si otn iasp.mtlaae +1


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