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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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taionrlAte fo eht chttarimsoet est nipto is a hcpahlmyiato epcross tdaiedem by trsgpialoadnsn adn si nedteidnepn fo het icypsmtehta unesrov tssmye.

B, C, D, adn E lla irerqeu cymhtsitpae sevner ot llcitie a rseoepns.

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pg32  nCa nyeona lipanex eht mcaismenh ehnibd gheiinrvs nad het chmtiytsepa oesvrun s?mytse +4
mdmikek89  Hahstpoyumal yaeslr outhhgr eht atnoiocum ruvnose et.mssy uYo ctu teh ,alrey you anc noly aghnec het tshtmeicorta ets n,otpi utb eht ydbo nc'ta rteac. +1
umpalumpa  s,Guy I iktnh hatt rof eth gernsvhii antitlaerve eth ponti si NOT atth atpesitmhyc renesv oorctln vgrehisni auylclta,( I 'tehanv fnuod cliaestr no bmpedu htta syas ahtt ihnegivrs is oondcleltr by shcpt.)timyae TeH etsiesa wya ot tihkn is atht iths tp hsa a emisycts ieifncotn aak( SmecyIiSRts-s fyoatmamlrin sneopres srem)dnyo. In SSI,R pt nac aveh &3l;5tT C ro g&38t; C, UTB ti is reom mcoonm to eavh ervef thna eohymtaphir. eogiCrnsdin si,ht uoy nac iylase -oluteru het hignvrsie alanrt.vieet +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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tpaulHhyaosm trlonlginoc rmutpeeraet tes nitpo si lreyfib nieondmet ni tamoaPh 8120 ioidtne epag 1,3 rpaethC 2 III aaidClnr ginss of lonmmatiiafn D. eFrev

gyenoPse -g&t; meapahgroc ereleas 1LI- adn TFN &g;-t eicnasedr osoaencyyxcgel aicttiyv in suyhthmolaap aarpvcesluri eclsl -tg;& saneicedr aoslamuhhypt PE2G -g;&t sdeair urrapmteeet est optni

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 +0  upvote downvote
submitted by gribear(0)
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Cna noomees xalnpie hwy hwen oyu enttscar eht pnlisa docr ieouprrs ot het velle of cymatithspe owltufo -- dna uyo gte a syemitsc netfionci -- eth ropsenes is aetroatlni fo het etharsmcotti tse tip?on

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its_raining_jimbos  oS I echso tath eon aebsecu tse tinpo si enlltoocrd yb the asthlymhoaup PEG(2 nda I-L1 eadetmi freve ni eht sahphoumyla)t adn het tser fo the anesrw oehscci nilvevdo sgehonitm bwleo het vllee atht sah bnee c.seeanttdr tNo %100 resu if โ€™tstah artcecua gu.ohth +5
noselex  dreeAg htiw _@i_sgmntbainsirjio -- vFeer si taddmeie by rntailge tse onpti in usptlyohham.a lAl teh ehrot sihoc,ce as rfa as I cna tell, nivlevo thcmpeiytsa neersv dna eitrh ftefces ta artget naso.gr +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 tgo hits tnuoiqes wognr, tbu i tinkh whta shit ostunieq is rllaye nsgiak si wtha npasphe ni a tmyissce fiioctn:ne wchhi si eerfv

in ctemyiss eioncf,tin eth tmos ivobuso insg ot okol orf is a f,ever nto eirlcsenysa siihrveg,n asnewtig, thea rntuoidocp yb nwbro ,tfa ct.e

dan who soed evfer uccr?o leki nmesoeo drealay :eontndime sgnpeeyo -&;t-g pamrocsageh gsnealier 1IL and TFN iwhch nersicaes XOC vaitycti in ahoplauhmyst svaecrraplui lel,sc eiarcsne iudontcpro of EPG2 ni aulomhptyhas dan esetr het pueatteerrm ets iot.pn

i nhikt the whoel prhaes tc"loepme nasortcetni fo eht lpinsa cdor epsoiurr to hte evlle of a.ms"tiy.pect.h si a trti.sodinac ti stuj ltsel you ttah eolvtepdenm of a efver hsa inhognt ot do hitw it

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j000  mneotepdevl fo a vrfee ni tyceimss nfcieonit hsa ihnogtn to do hwti yapietschtm svuenro ,wofl so evne sti' nr,diuej ervef wdluo ltsli ruco.c I khint isth eusnioqt is tusj kngias woh deos fvere uoccr in eo/innmataictnflfnomii itosani.ut +1
b1ackcoffee  oS, owh od oyu enilpxa the ctuala everf yb utsj nhngcagi eht t?romt?hseat Ferev 'ctfefe' SI runed aymStteipch on,rctol jtsu eth ggnnihac het arperetmetu (ielk atemh)stotr is mtideead by ioektycns nad ayo.hulhmatsp +2
j000  oh i see hawt yuo mea,n ewll i n'dtdi okwn taht, os ntsakh orf fainirclgy tth.a v,oerewh dbaes no oyru pontxla,eain ti lwuod lilts egt su ot eht hrtig warnes chihw si rota"liante fo thmtrotieacs ste ,tnopi" not het eefvr cftefe eisf.tl +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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kyaO bosy and lsigr shit useqnoit si ireesa nhta ouy nkh.it

ystohlHmaupa ylsear vai eth astpheytmci ersuonv esymst ot cltnoor het obdy hwen a nwe est point as nebe derchea in eslt ve.es.fa..cear.suy. .eb.fyi.oti.n.nc

If teh oeocninntc enbtwee hte hlmstyaohuap dna nsplia crdo ilnm(ay het ayhpmcisett ftuoolw) is t,uc het tmhasalu aonnct arlye the bdyo aterncoi of a v,rfee utb teh uhomsahaplty tiflse nac lislt aehncg teh tse ntoip.

omBo

Wniith eth bar,ni eht iuooatnmc nvureso tsysme si tauldrege by het oatyplshhmu.a noitomucA ntisoufcn cuidenl ocrtlno of epiir,ontasr icacdar rlgienauto eht( caridac ctnrool ,)teecrn otvmraoos iatiytcv h(te osovoatrm )ecrtn,e dna iretnac fxrele otcsian uhcs as gn,coihug i,seezngn llainwsowg and m.ntigiov

EB- rccou as a lurset of a nhgcae in set .ontip

A aspneph to uaces eht -BE whne a new tes tpion si h.dareec

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In ymtessci tnonc,eifi t'dwnolu you etg uusaectno NaDTOLIAovIs e..i( udittbeivsri hok)?cs sTih swa ym seoarngni ofr noosihcg )B ni siht yckaw u.toqneis

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neilfespiritu  emaS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Fmor anohkryeoeonkduHS no ird:det

hatW the toqneusi is neittgg at is eth cyapetitsmh hinca was as.dper It wsa a ieelrbtr ayw fo iognwrd t.i

oYru rneorita ytamlsahophu is ebopisrlens rfo goniolc aefesurt dna is nerdu ptypcamtsaireha loctron. A nleiso wudlo eusca amtehiy.rhrpe

ruYo optrisreo luapohatmshy si elnrpsoesbi rof haentgi henw rue'oy lodc and ot ntgeeare eht veerF pornssee dna is eudrn amyttchesip l.ctoonr A insole loduw caues t.arphmyeioh

nI htis iuntqeso it is miplsy kniags a resopn tsge si,kc olmhuhstapay aws pdes,ra twha .npsehpa

nrswAe: ayphoauthlsm lliw tlisl be labe to aeeevtl tse odyb teueprarmet to tlbtae iincf.noet

tHin: FI htey veig a tnqeoius miarsil ot hist tbu rdwrodee to dienucl a niseol fo het tymesihpcat febrsi ro of the o,phhatlysmau ouy udowl in ntur TNO eb able ot tereaneg a efrev npeoesrs to ifon.cntie ehT huslaayhmtpo wluod be tnreeiyl denru esppaitaaryhcmt ornolct

This asdd omre oxcentt ot teh fact het Q ttssae atth het itsspatcyehm saw epdars

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oslerweberrendu  oS, itsh ayss hecatimsypt osal saperd dna auyosthhplam oasl p.ardse neTh hwta asw ognwr with iths ccliainl es?ca? +1
adong  i knhti the iscmyttapeh syesmt si cyualtal eimiadpr b/c 'its utc befeor it cna olu.otw".".aft letsa t'si het lyno awy ihts ksmea snsee +4
suckitnbme  I e.erag I intkh the sneituqo tmes is gasniy hte shcmsyatteip eewr s.oleneid Nto atht tyeh erew s.aedpr +4


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