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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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lteaiortAn fo teh straimtchteo ets tniop is a pitclyohahma ceropss demedati by ronasipgldtsan dna si ntnnepdeeid of hte hcatpsmyiet enuosrv msyets.

,B C, D, adn E lla eriqreu sihtaempcyt rnseve to licleti a .rsonpese

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pg32  Cna yaeonn inalpxe hte mcnmisahe ebdihn gniisvhre adn teh hsatcpityem venruso tyesm?s +4
mdmikek89  lshHaptauymo yrasle orhhgtu eht aunmctioo rnsouev tysm.es uYo ctu the lyare, oyu cna noly ecahng eth oitcehasrttm set poti,n tub hte body 'nact ra.ect +1
umpalumpa  Gs,uy I nhkit that fro eth nvshgriie vnletatraie eth tonpi si TON atth ceyhttpsami vsreen trclnoo einvisrhg actlya,(lu I hntev'a oufnd etislarc no dbuemp ahtt says thta hivnersig is nldcooelrt yb )peyihctst.am HTe teaseis ywa to kithn is ttha htsi pt sha a tcsimyse tficnnoie ak(a IRtssSeimcy-S mfatlionraym persesno osn)ydmer. nI RISS, pt nac heva &35lt;T C or t&g3;8 ,C TUB it is rmeo ocnomm to hvae verfe hnta hphoetr.iyam gndoiCrinse t,his yuo anc yaseil l-uuoret teh iniehrvsg viraeltnt.ae +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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saotalhyHpum rgtllnncioo muraepteret ste tpnoi is erblyfi mneoneitd in mthoPaa 8102 niietod gape 1,3 pteChar 2 III aildnCar sgnsi of mfaionltmnai D. erFev

eygnoesP -tg&; aocmaephgr eslreea 1-LI and TNF tg-;& edcersnai oegyxcylacneos yaticvti in masatluyhpho uvceirasplar llecs ;t-&g eieardcsn lhsutpyaamho EP2G ;g-&t rdsaei prmateetreu tse ontpi

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 +0  upvote downvote
submitted by gribear(0)
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naC oenmsoe xipenal wyh ewhn ouy ascntetr the nspali rodc prieosur ot hte evlel of mtceyaipsth wutoofl -- dan ouy get a iycessmt fincioten -- hte senepors si nlroaiteat of eht mttrhtioceas tes itnop?

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its_raining_jimbos  oS I ohcse atth oen sueecab tes tnopi is ltoodcernl by het aomhshplayut G2EP( dna IL1- ietadem rfeev in teh l)ouyhmtahasp nda the rste of eth rwnsae cscohie ovnvdiel mhostgnie bewlo teh leevl tath hsa eben catees.drtn oNt %010 sure fi saโ€™tth teccaaru tgh.ouh +5
noselex  eArged thwi i_stboirn_@jaimsing -- vFree si demiedta yb trnelaig tse nopti ni oshmlauhp.yat llA eth teohr cisec,ho as far sa I anc lel,t invloev itpchyetasm neevsr nda tierh ffecets at teartg ros.gna +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 isht oesqntiu ,ognwr but i hntik thaw htis tuesinqo is elrlay akgins si thwa hpsapne ni a escsyimt enito:ncif hhwic si reefv

in issemtcy ecionfin,t eth tsmo usbvooi nsgi ot okol rof is a v,rfee nto recsaenlyis visng,irhe intsge,wa haet ntcroipuod yb wrnob taf, te.c

and how esdo feerv rcu?co like esoneom edyrlaa dteeoimnn: eosgpnye t-&;-g crhpsogaema eelnaigrs 1LI dan FTN hhcwi sseecnira OCX tiicvayt ni losamuthyaph euracsvialrp sc,ell seianerc icrptoodun of 2EPG in thpmausylhao adn estre hte temrepturae est p.tnio

i hitnk the wohel hrspea l"oetmecp tcanisotrne of het aspinl cdro ispuorre to eht elvel fo ytpe.tsc.ai.mh" is a iadiostct.rn ti ustj tlsel uoy htta mvpondetele of a reevf ash gnthoin to od thiw it

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j000  eenplmdvote fo a reevf ni cteissym cfennoiit ahs gniothn to od htiw iecahttmpys nrvosue f,owl os vene 'its urdeinj, frvee owdul slitl rcc.ou I ntikh iths osiqnuet is jsut ignaks hwo esod freev rcocu in noanmac/oiiletifntfinm .tiuaositn +1
b1ackcoffee  ,oS hwo od uoy alpinex eht ctaalu rfvee yb ustj cingghan het ttr?mas?othe Fveer 'fftcee' IS udrne hapteyicmSt cn,rotol tusj teh ingcnahg het rraupemetet (kiel sttetmhora) si dtaidmee yb sycteniko dna atmayphsl.hou +2
j000  ho i ees htaw ouy anm,e well i itdnd' okwn ta,th os tnaksh ofr yiglfacnri tt.ha r,vweeoh besda on royu nei,xltnopaa it dlouw illst etg us to eht ithrg sweran cihwh is tlnia"aotre fo csmtrieaotth ste ip,not" ont hte rfeve fcetef fe.tisl +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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aOky oybs nad lsrgi shti utnioseq si iraees naht ouy ntihk.

Halymtuspaho elsrya via het cathyeptmsi snveuro msyest to olntorc hte bdoy hwne a wen ste ntopi sa eneb radehce in ltse eces...a.svaey.r.uf yo.nie.t.bficn..

fI eht nctonineco tbnewee the uaymhshatplo adn lipasn cdro ailyn(m eth aehmtitpcys ou)otflw is tu,c eth uahatsml natnoc yerla hte boyd aceronti of a rv,fee btu eth asayulphthmo sfeitl acn still negcha hte ste it.pon

omoB

iinhtW the bai,nr eth utoaonmci nrvsuoe emtyss is aeetdlgur yb hte hophtamslayu. ooicAumnt icnfosntu lnedcui conlort of ,aipoentrris iccrada lgtieaunro the( carcaid lrooctn r,t)ence ormoatvso taitycvi (the srovomota e,ec)tnr adn taeircn fxlere stiacon such as gncuoihg, g,enznsie owgllnswia nda ivimgto.n

EB- uccor as a tulres fo a neghac ni ste nop.ti

A phnsaep ot uacse teh BE- nehw a wen est oipnt si edch.aer

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In tiysecms efni,ncoit lnwtdo'u uoy gte unsocteua DIIsNOTLvoaA ei(.. dvruiiebitst os)c?hk hisT wsa my asngroeni ofr sigchnoo B) in htis cwkya enqsotui.

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neilfespiritu  eSma +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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omFr kayneorkoeuHondSh no e:trdid

haWt the utsoqien is iengtgt ta is the eyhpmtsaitc ncahi was desa.pr It was a rtbreiel ayw fo wngdoir ti.

Yuor nroratei autyasmphlho si sporeibesnl orf nocgoli taeufrse dna is nuder tspthimaepacray .rnotloc A ilsone uodwl cuesa prarheeyi.thm

orYu rproisoet talhmpuahsoy is oeleinrbpss rfo entghia hewn rou'ye ocdl adn to eaetgrne teh ereFv osenespr nda si enrud satiyheptmc rloot.cn A iosnel wdolu ucsea tpmro.ehhayi

In tsih eustioqn it si pmlyis sanigk a erspno setg csk,i hustmholpaya was ,esdapr twha eppahn.s

nwe:rsA plmtyahsahuo wlli lilst eb able ot teaelve tes bydo eetratrpmue ot bttael tin.oniecf

:Hnit IF hety gvie a iqsntoue iasmlri to tsih ubt redoerdw ot udiceln a nolies of the imyhcspatet fbires or fo teh taylsaomphh,u uyo uwldo in nurt OTN eb eabl ot eetgnrae a eferv roeespsn ot ontciief.n hTe otlphauyahsm udolw be enrieylt unrde teasmyhpacitrpa olorctn

Tish adsd rome conttex to the ctfa eht Q tsaest atth the isathtempcys was edaprs

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oslerweberrendu  ,So ihts syas ctthiesmpay asol psarde and olatysaupmhh loas drep.sa Thne wath was nowgr thwi iths linialcc ac?e?s +1
adong  i ktnih het itmseayhptc tsemys is alcltayu dapeiimr /cb 'its utc beofer it can uo"."ota.ft.wl tales sti' eth oyln ayw isth kseam snsee +4
suckitnbme  I agr.ee I nikht eth iouqnest smte si giysna eht etihsapmtcys ewre de.ilsone Nto ttha yhet eerw aspder. +4


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