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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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noAertiatl fo eth ohittrsatemc tse nitpo si a mtlahcpyoiha opsersc mdeiedta yb gsndatsiranpol nda si deeenpdintn of teh asimthyectp nvresou msstey.

,B C, D, dan E lal eiurqer cetpyhaismt eevrns to iellitc a es.spnreo

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pg32  Cna eanony eiplanx eth nhsmmaeic bnihde nisivregh adn het tmtaiyehcsp rnvoesu ?ytsesm +4
mdmikek89  usaopyalHhmt searyl thhorgu teh noicuoatm osvneur stsmey. oYu tcu het ,rleay uyo nca nylo gehacn hte tetmashiorct tse npiot, btu eht yobd na'tc t.eacr +1
umpalumpa  G,usy I nihtk tath for the iievgnshr aentleiavrt the oitnp is TON ttah ahsmtecypit vrnese rtlocno nehivsgir laatuc(ly, I eat'vhn uofdn stceliar on bmudep that yass htta rvieghsin si dotrellcon by ic)stpemyah.t HeT eetsais ayw to thkni si taht ihst tp hsa a imcysest nfnticoie kaa( cRSi-tmIySess fnmtomraliya ospeesrn .msoedy)rn In SISR, tp anc evah ;l&t35T C ro 8&3;gt C, BUT ti si orem comnmo to aveh evref anht mehiyahtrp.o girosnCendi tis,h yuo cna ysaiel t-uerolu teh gvsrnhiei ialtrveae.tn +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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ushlpotmHaya nigncotorll taempretrue ets ntoip is bfliyre omnnietde in Pmotaha 8201 itidnoe apge 13, eCrptah 2 III ridanlCa ignss of mflnnimtaoai D. Fevre

nseoePgy ;-g&t camphgoaer eesaerl 1-LI and NFT tg-&; eacsirdne ocexolyscynage victayit in yutahlopmhsa perravsaluic lslec g;&t- eacniedsr aohshylupmat 2EPG >-; seirad etaetepmrru ste ptoin

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 +0  upvote downvote
submitted by gribear(0)
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Can omnseeo nleaixp yhw ewnh you rtatecns the ilnaps odcr rsopueri to teh evlle of mhasyteticp oflutow -- nad yuo etg a ysimtsec ecntinoif -- het resopnse is rlatintaeo fo the teiamhtctors ets npot?i

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its_raining_jimbos  oS I hosce taht one subacee tes notpi si todcnlerol by the hylmapstuoah G2(PE adn -1LI eemaidt freev in hte aloutpsa)hhym nad het esrt of hte rsawne icsecoh dolvnvei mehosigtn bolwe teh evlel ahtt sha bene .etcetnasrd Nto 100% uesr if โ€™thast rtaacecu uthhgo. +5
noselex  eeAdrg twhi @oi__mignsnajiisrtb -- erFve si tddeieam yb tlanierg set opnit ni saltho.puahmy All the orhte hcsoic,e sa rfa sa I nac e,llt ivolevn theptycsaim eernsv nad ireht fsectfe ta rgttea na.gors +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 got ihts tnusoqie no,gwr but i tihkn whta tihs nuisteoq si leayrl gnkisa si wtha shpnpae ni a tsimseyc nfe:inocti wichh si evfre

ni ssyitmec ,nofteiicn eht stmo ubvoosi ngis ot ookl rof is a erf,ev not ryssienlcae egsin,rvih a,iegwtns haet ircutnoopd by wonbr ,fta tce.

adn woh soed feerv oucr?c leik omesneo ayrlead mnetde:noi gpseeoyn ;&-gt- poagharesmc iarnseegl L1I adn NTF hiwhc acrisense COX aiicytvt in aaytpshmluho csviruaelarp ls,cle sciernea orntopduic of EP2G in ltosahamyhpu and rseet teh emrtaetpure ste nitop.

i khnit the wleho prehas "ploeetmc atroneisctn of het pnslia cord orrueips ot het vllee fo ."sytmctpi.a.eh is a otndiitasrc. ti sutj tlsel oyu htta vneeemlotpd of a fveer sha gnotihn ot do itwh ti

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j000  oenemvldetp fo a ervef ni mcestsiy niinfocte has ontghni to do hiwt hptscyaemit uvneros ,oflw so vene si't jdi,eurn evref luwdo ltsli crcuo. I nkhti htsi eonuisqt si sujt nisgak hwo dose vfere ourcc ni acntao/itlemomfinfiinn siuat.iton +1
b1ackcoffee  oS, woh do you eanipxl the aactlu rvfee yb stuj gagicnnh eth oter?shtatm? eervF 'e'tceff IS rednu etiSyatcpmh ocrn,tol sutj hte ngnaghci hte reaetmpeurt liek( othat)mestr si admdeeit by kostcynei adn uamhoyhltspa. +2
j000  oh i ees hatw you nmea, lwel i nddti' wonk atth, os satkhn for incfrlaigy at.ht heewv,ro sbdae on rouy inaenoxtalp, ti luwdo siltl get us to eth thrgi ranesw hciwh si ataoi"lrtne of recthamstoti ets ",topni nto eth freev etcffe sltfe.i +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 sboy adn lgirs siht ostuqein si seiare htna oyu n.khti

auohamyHslpt ysaerl via the hittysaecpm nsuevro messyt to otrnlco eht bydo wehn a wen tse tpnoi sa enbe craedeh in lets svru....saae.yceef. y.cfini.to..nb.e

If the oniotcencn beenewt het mhoaaltshpyu dan sanpil cord yinmal( hte ethyapmscti lowf)otu is tuc, het atlumsha onntac arely eth oybd ecnaitor fo a fvee,r tub teh hhamuapsolty tlefis can ltlsi gechan the tes ntp.io

ooBm

hnWiit hte ab,rni teh ianotmuco snuvroe tessmy si lreueadgt by teh yphlsatouhma. oAcmuotin tnocnuifs ciuledn colnotr of strier,inpoa raiccda rnuogaietl t(eh cacdria rtnlcoo c,e)retn aotsroovm itvcytai th(e vmootraso c)nre,te adn naitrce xelref ctnoais hsuc as nugoc,hig g,enzesin lsowlnwgia dan itiov.nmg

-BE rcuoc as a tursle fo a gehanc ni tse ipto.n

A eapnpsh ot csuea eth B-E nhwe a new tes iotnp is dae.hcre

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI stsmiyce ntnie,cofi t'luodwn uoy gte ecoutusan IsOTaIADLNov e(.i. deuttviriibs s?koc)h shiT wsa ym raioegnsn orf socgnhoi B) in ihst yckaw onestuiq.

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neilfespiritu  Seam +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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oFmr HndkrShoyeoanouke on :idretd

tWha teh sqtneuoi si gtgtein at is teh esptcymhati hinca saw e.rpads It asw a lerbtrie yaw of dowigrn .it

Yruo enirtroa thlhuysopmaa is eenlbsorpsi rof nlgcioo uefatser nad si rdeun aprcsaamithpeyt .lrtcoon A nlseoi woudl saeuc etpmrary.ehhi

uoYr orprtisoe sapmoahutyhl si eilosrnpesb rof hteinag nwhe 'oeuyr cdlo nad ot nergteae teh evFer pnsresoe nda is drnue ysaitetpchm ontorl.c A snioel uldwo ausce maph.trhoyie

nI shit estiquno it is yispml ksnagi a rseonp tges sc,ki ayltuhmoashp saw adeprs, waht ean.hspp

ew:nsrA tahylpsamouh lliw lislt eb labe ot evtleea tes ybdo utraerpemet to ltebat i.tncnioef

Htin: IF hyet give a uiotqnse imlrsai ot hsit utb oddererw ot neiculd a nliose fo eht tyispmhecat esfirb or fo eth hslamut,ahpyo uyo luwod in runt OTN be elab ot eteanerg a vrefe nosperse ot fint.ceoin Teh yhpmoalhsuat uwodl be lrneyiet udrne htiyptesamraacp roctoln

Tshi asdd rmoe ttcexno ot eth ftca hte Q ststea thta hte tieysathspcm aws arepsd

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oslerweberrendu  ,So hits asys atmicspthye salo adespr adn lhusthapoaym oals s.darpe nThe hatw was ongwr tihw itsh ciicalnl es?ca? +1
adong  i nhtki het apitmytesch tesyms si lalacuyt pmiraied c/b tsi' cut rbeoef ti can to.w."ofau.tl" salte 'sti hte ynlo wya tish akmes eness +4
suckitnbme  I eg.era I hntki teh estnuqio tems is yanigs the hsytpsmcieta erwe s.loendei otN thta yeth wree depr.sa +4


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