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Retired NBME 22 Answers

nbme22/Block 1/Question#35 (reveal difficulty score)
A 35-year-old man is brought to the hospital ...
Alteration of the thermostatic set point ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +20  upvote downvote
submitted by โˆ—keycompany(351)
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enrlottiAa of eht srtchotimeta ste oitnp si a lpymhaotchia reospcs maeedtdi by ariapsngotdlns dan si eneedndtnip of hte htcspeitaym uovsern smtsey.

B, C, D, dna E lla irrueqe tmipthaysce envrse ot ctillei a res.pseno

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pg32  nCa aenyon alnpeix teh esmmihacn hniedb grisehniv dna eth etthpymcias rsevoun etm?sys +4
mdmikek89  msatalohHpuy aersyl hugtrho teh uacotionm ersvuon ssem.ty oYu uct the eyarl, yuo cna lony nahgec eht tmteosrahict set p,onit but hte ydob c'nta rtc.ea +1
umpalumpa  suy,G I itnhk ttha orf teh hsivernig raietevantl the otnip is OTN ttha icsteptyham envres oolcnrt irngshiev ay,lu(tcal I vetna'h ofnud ectrslai on mdpbue thta ayss thta siihnegrv si rldolcteno by yhtceptmi.)sa eHT seeasti yaw ot hknit si ttha itsh tp sha a symsteci oinftcine aka( yi-mtsSceSsRI afiamonmtrly rneopess syeomnrd.) In ,SISR tp nac hvea t&3T5l; C ro g;8t3& ,C BUT it is remo mcnmoo ot evha vefer ntah theiphyamr.o ngoedinrCis hsti, you anc easyli t-loureu het nviihegrs evlanrit.aet +1

Even brown fat needs SNS == release of NE == binds to beta 3 receptor on fat == uncoupling of ox phos!

+6/- apurva(101)

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 +4  upvote downvote
submitted by โˆ—qfever(67)
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tmspylhHoaau onrlliontcg taumrteeper ets nitop is rfiybel ineomendt in Ptamhao 1082 tiodein gpea ,31 tCarhep 2 III dirnlaaC nsisg fo nmtolafmaini .D eeFrv

soPgyeen t-&;g aargpohecm sleeera I-L1 and FTN &;-gt acneridse cosalgnoxyceey iciyattv in yaomluhthsap arresvaupcli cslle tg-&; deasceirn hhyoulapmtas E2GP tg-&; erisda etprermetau set opnti

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 +0  upvote downvote
submitted by gribear(0)
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aCn enoseom elxpina why nhwe you tcnearts teh sapinl rdco rriueosp to eth evlel of htyepatscim lwouoft -- dan oyu tge a eicystsm tcienfino -- eth sepersno is tloaenitar fo teh cmhstrttaioe tes itno?p

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its_raining_jimbos  oS I cohes atth noe sbucaee tes tpnio si lroctlendo by het shaomlytphau G2P(E nad I-L1 miaeetd revfe in hte t)myslahauohp nad het stre fo eth ansrwe sehcico oldenviv gmshoniet owelb the evlel that hsa bene tadetrnsc.e Not 0%10 esru fi shaโ€™tt reaacutc uo.hgth +5
noselex  deAgre htiw sraintimbji_@go_nis -- veFre si demtiead yb erlgitan tes ntipo in a.yhulhpatosm All hte eorth cieho,cs sa arf sa I acn ,tlel lvinevo ctpiamhytse evrsne dan tierh eectffs at eartgt ognsr.a +2

You might not be able to change the temperature because you have no sympathetic outflow, but the actual "resetting" of the thermostatic set point is mediated via the hypothalamus and prostaglandins

+2/- spow(50)

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 -1  upvote downvote
submitted by โˆ—j000(17)
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i otg hist iuenotsq gn,rwo btu i knhti hawt this iotneusq is eayllr gknsai si ahwt espnhpa ni a msticesy nceitif:on hhicw is efvre

ni secmyist nof,enitic het mtos iovbosu gins to oklo for is a veef,r tno eaesiysncrl ,viiesrnhg ,sniawtge eaht dtnoicroup yb rbwno a,tf .tce

nda how dose frvee cc?rou leik ooseemn laeydar en:ointedm poeyngse gt&-;- rpgaomcshae iaerengls LI1 nda NFT iwhch esnesriac OCX tvytacii ni omalpuhyhast auiclvsrraep lsc,el rsicenea rpoindtcuo of EP2G ni puoamashthyl and setre the rteeemtprua tes t.poni

i nkhti the leowh seharp pol"temec reitatnonsc of eth anlisp rdoc eruiposr to teh evlle of astyci.tmehp.." is a irnod.icstta it tjsu tlles oyu htat emnvdopelet fo a eevfr has gnhnoit to od ithw it

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j000  veomenldept of a verfe ni yceitsms eincfniot has tningoh to od twhi ptseytmcahi vrusneo oflw, so vene 'ist rnue,ijd eefrv uowld iltls ccr.ou I iknth isht uoqsinet si tsuj iaskng hwo esdo rfeev rcuco ni tmeionilfiof/tannciman nosuitat.i +1
b1ackcoffee  o,S who od oyu linxape eht atlauc fever yb jsut ngcghian teh satrmht?eo?t Fever f'tfeec' IS edrnu mctShpaieyt ort,ncol sutj eht nhcagign het mreeupteatr e(ilk trsheot)tma si deedtmai by iensctkoy nda mosaauhphylt. +2
j000  ho i ees wath you a,nme ewll i 'niddt ownk ah,tt os nsakht rfo rlfyacgnii a.htt ,rvowehe asbed on yrou ,nxilnetoaap it odwul illst get su ot eht rtgih sanewr hicwh si oil"ttnraae of irocethsttma ets n,it"po ont eht evfer teceff eitl.fs +1

So, how do you explain the actual fever by just changing the thermostat?? Fever 'effect' IS under Sympathetic control, just the changing the temperature (like thermostat) is mediated by cytokines and hypothalamus

+1/- b1ackcoffee(115)

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 -1  upvote downvote
submitted by โˆ—mdmikek89(6)
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ykOa ysbo adn rgsli tshi noqtseiu is aseeri tanh uoy ih.ktn

mayuasltoHhp yarlse iva the tsthyemcpia eurvnos ysemts to lnotroc het bdyo hnwe a new tes ipotn sa bnee rhacede ni stle ..ufcae..se.r.eyvsa tyn.n.obf.i..cie

If hte niotccenon eewnbte het uhalshtmyoap nad inlasp ocdr my(lnai het iyestptcham ofow)lut is tc,u eht aaltmshu tonnca aelry eth boyd acrinteo of a vr,efe tbu eth tlayopshmuha ifstel nca ltlsi eahncg eth ste .ponit

Bmoo

ihWtni the ,inbra teh omaocnuit srvunoe sseymt is agelutder by eth lsh.apumahyto tcuoinmAo niocusftn udenlic nlootcr fo ,iortsprinea caidcar tgioanurle ht(e aiccdar trcnloo tcre)n,e aosmvorot ivyttcai (het sotoamrvo ,)nrcete nad tricaen xelrfe oanstci such as cogniuhg, isg,neezn iwnsgwalol nda io.igmnvt

EB- ccruo as a erutsl fo a nhegca in ste ni.tpo

A panhpse to acues eht E-B nhew a ewn ste pnito si eae.drch

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI istcmyse fnioec,tin d'wtulon yuo etg socuntaue LaTIDOvoAsNI (e.i. stvdtiueirbi hkcs?)o sThi aws ym oinesrang fro osinhcgo B) in htsi wckya uetnsqoi.

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neilfespiritu  emaS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Form nnyeukrHSkhodoaoe no teird:d

tWah eht sqoeutni is etnigtg at is het stthameicyp chian wsa ers.dap tI was a birleetr ayw of wndroig t.i

rYuo orireant saplouthhamy si breeslpoins fro nogocli eurafste nad is urden tpshcrmeaatipay o.cnrtol A lieson owdlu aucse ih.tperrhymae

Your poirtoser tmahpuysaohl si ebnosresipl orf athengi ehwn oyr'eu cldo nda to gterenea eth Frvee roesnsep dan si deurn shctyetmiap ctr.olon A noesil owldu ausce paitmhhyroe.

nI hits insoqteu ti si spmily kgsain a enposr gtes ,cski pyaumlohhast saw spdera, hatw nphapes.

:ensrwA aslhotmpahuy iwll istll be beal to vaeelte set odyb mpeaeteurtr to btaetl .ifnncoeit

ti:nH FI htye ivge a ostqniue lismair ot thsi but odrwdree ot ieculdn a noleis of teh maecpyhttis sbreif or fo eth pumthaasyloh, yuo olwdu ni nrtu ONT eb elba to eenaegtr a vfere psenosre to neiciotnf. ehT aohauymsthpl dwoul eb nteireyl udern rtahapeatpcsiym trconlo

ihsT dsad reom toextcn to teh cfta the Q tetass atht the tmpihctyessa swa pardes

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oslerweberrendu  ,So shti yssa cpithystmae oasl pradse nad pthalysmohau asol sdap.re Thne tawh was gnwor wiht shti nllcaiic sc??ae +1
adong  i tknih the yhmtatipesc metyss si ylaltacu ierdmiap b/c i'ts utc oefbre ti cna .ao"lt.fwo.t"u aelst 'tis het olny yaw this eskma sesen +4
suckitnbme  I eg.ear I knthi het tuiqonse estm is sagyni eht ahipsscyetmt wree eeions.dl oNt hatt hyet rewe sr.dpae +4


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