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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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Arontltaie fo eht ciotsetahmtr ets opnti is a ytocahmphlai pescsor damieted by natoiglsdnaspr nda si edneptiennd fo eth mshyaitcept vonusre ysmest.

,B C, ,D dna E lal qeuirer chmsieyttpa everns to tceiill a ee.rspons

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pg32  anC nnayeo eilpnax het iamhsnmec hbndie rihseinvg nad het ethyimpatcs oesruvn yt?mses +4
mdmikek89  ymahautHpols easrly rhguoth teh coomntiua vroeusn .smsyte uoY ctu het ,rylea uoy anc lyon naehgc eht erattchiomst tse otip,n ubt teh dyob tcn'a acre.t +1
umpalumpa  u,yGs I nthik htta fro teh higsnriev nevretitlaa het ipotn is TON ttah hsacmeytpti evresn ntoolcr iehivrsgn c(alua,tly I a'vthne fnoud ilrtcase no ubpmde that sasy ttah niiregvhs si cltoorlned by tatpmy.chei)s eTH taesesi way ot ktihn si ttah hits tp hsa a symitcse niocfiten ak(a tisSmsySIc-Re mymaartnoilf orsnepes rye)d.snom In RS,IS pt nac ehav 5l3;tT& C or ;8&t3g ,C BUT it is emor mcoomn to haev evefr tnha t.oraeiphyhm negrsinCido ith,s uyo cna lsieay uutlr-oe teh iigrhsnev evtitearnl.a +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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Hsphmoytulaa ornllocgint etupaemtrre ste tnpoi si yieflrb idtmnnoee in Patohma 2081 dtioine gepa 31, Cahpert 2 III aCidraln insgs of afmolnmintai .D Fveer

osnPeyeg -&;gt gempacohar eaeesrl I1L- adn FTN g;&t- iansecdre cexceloyngsayo tytcaiiv ni psyothmlaauh raicsrvuelap clesl g&;-t neairedcs oymhpalashut P2GE g&t;- sdeair pteetmuarre ste tpino

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 +0  upvote downvote
submitted by gribear(0)
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Cna oesmeno nlepixa yhw wenh uoy ansrttec eth spanil ordc pseuiorr to teh velle fo imtschpaeyt lowutof -- and oyu etg a seimtcsy icefnnoti -- eht spsnereo si lrttoieana fo the hastiomertct tse to?inp

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its_raining_jimbos  oS I heosc tath neo esaucbe tse piotn is lrtcooendl yb eth haphotalsyum GP2(E nad I-L1 imtedea evefr ni the hhumtsal)oypa nda eth estr fo eth esawnr soehcic dovinvle nmeothsgi woelb eht lelve htat sah eebn atdtce.rsne Not %010 reus fi sathtโ€™ cctaerau tghouh. +5
noselex  Aredeg whit itassb_nirion@mi_jg -- vFere si ameeditd by tlargien ets pnoit ni s.uatphyohlma lAl the teohr scchio,e as far as I cna tel,l ioevlvn pmatcyitesh reesnv dan rheti feetcsf at aerttg oasrng. +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 sthi uqenosti ngw,ro ubt i intkh htwa iths isqouten is ylrlea aknsig si whta shppnea in a itcsmesy o:cnieftin hhiwc si evref

in smtecysi ntfenioi,c het ostm soivuob sngi ot ookl fro si a vreef, otn larseciesny e,srhviing egawints, aeth odritpcnou by bworn taf, .cte

dan woh sdeo efrve crouc? ekil eoesonm ayareld tenideom:n yneegops &-;t-g gcsempaoarh ansereigl L1I dan TNF whihc iaesescnr COX yatiictv ni yasatophhmlu lvaeuicrrspa ,ellsc eariesnc pootunrcdi fo P2GE in ylpouhtasamh nda stere the mruepreeatt ste tnp.oi

i ihntk eht owlhe pharse eotecp"ml iersacnntot of eth sipnla ordc oreuiprs to eth elelv fo tpt.yea"mi.shc. is a ntcdois.itar ti jtsu tlesl you atht tedlmepveon of a veerf ahs gnoitnh to od ihtw it

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j000  doepeltvenm fo a evfer in tsycseim iifctnnoe sah tnohgin to do hiwt hecpmtsytai vneusro l,owf so vene st'i n,deurij vefre luowd ltlsi .occru I nkiht hsti stuoeqni is sujt ingask owh does verfe ouccr in noioamiefnitnnlcifma/t asittoiun. +1
b1ackcoffee  oS, owh do uyo xanepli the taulca eferv yb sjut gghancin het ?rtoahtm?set Fevre feet'cf' SI edrnu citSyaetpmh ocrl,nto jtsu eht aignhngc eth tertaeprume i(lek tt)ehsomtra is eiemaddt yb esntiokcy dna opa.tlhsmhuya +2
j000  ho i ees whta you ane,m lewl i 'dnitd wonk tah,t os kshnta fro iicnafylgr at.ht hvwoer,e aedbs no ouyr axeplno,anti it uowdl sltli tge us to het thrig wanser ihhcw is alertotn"ia fo itaetmrhsotc tes "poti,n tno het ferve eftecf lfis.te +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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Oayk obys dna rilgs isht isoeqnut is ieares anht oyu ni.thk

lahyapsmtHuo eyarls iva teh cayetithmsp onuesrv mstsye to nocrolt teh dybo wnhe a new ste intpo sa eben hdaerce in tesl evey.suc..es.fa.r.a .e.inif.n..ybtco

If eth oenictncon eewbtne the hyahtmsuaolp adn palins docr na(mily the smacpyeihtt folwut)o si ctu, hte aalumhst ntcano layer teh dyob iteoacnr of a evf,er tub het lashyauohpmt itesfl nca llist engcha het tes .niotp

mooB

niWiht teh r,bian the aomcinotu seovurn mytsse is traeuledg by eht mahtyaosup.hl oiAcountm nfnouitcs clneudi tolrcon of ,arpsnritoei dccaira iaegnutorl eht( idcaarc ortnocl rcte,ne) voaosmtro tyicivat he(t raoostomv n)erc,te dan eritcna eelxrf ictaons csuh sa ichgoug,n zenne,sig iagswolwln dan itogivmn.

-EB curco as a srtlue of a gehcan ni ste op.nti

A shpepna ot seacu hte -EB when a nwe tes ptnoi si e.adcerh

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI esymctis ifnnoice,t tl'wnoud uyo get ucusnoeat ADLNIoIvTOsa .(ei. tbrstiduieiv os?khc) ihTs saw ym goreninsa ofr hincosog B) ni ihts akwyc qesitou.n

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neilfespiritu  Smae +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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rFmo undroeokknSyHoeah no tidred:

thWa eht ntusqeio si gtientg at si eth hpatyisemtc nciah wsa pder.sa It wsa a eiberltr ayw of ridognw it.

uroY atoinrre aphmotlashuy si snrpoleiseb rfo logocni rtefuase and is drneu iaymrscptapateh octolnr. A sieonl owdul seuca .hrrehtimayep

uYro eisoportr thaumaoshpyl si rineopelsbs rof igntahe ehwn ryoe'u docl nad to ernaeegt het Ferev eprseosn and si nuerd hytsmcitpae rlntoco. A nesoli loudw uscae oae.rithpmhy

nI tish neqsuiot it si iplyms kignas a ernops gest s,ikc laphoymshuat wsa rpae,sd atwh shpaepn.

nrsA:ew hoapmaythlus lilw slitl be beal ot vleeate ste bdyo mtrteerepua ot ttaleb noicne.ift

iHt:n IF etyh veig a eistquno airmisl to tish tub deewrrod to lnuicde a ensoli of eth atmsihecytp fibesr ro of teh hotalyamu,hps uoy ouwdl ni rtun TON be eabl to nerageet a refve seernops to niofintec. eTh aolymhaputsh wlodu eb etylenri rnude ptaaacymeptisrh trloonc

iTsh sdad rmeo oecnxtt to het fatc eth Q staest hatt teh iyhespmactst swa epsrad

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oslerweberrendu  ,So shti ysas csyaptmehit aosl rsedap adn plsoayhamthu soal a.persd eTnh thaw asw wnogr hiwt hsti lcnailic scea?? +1
adong  i tnhki eht ptihstcmeya ymstes is latycula iarpmdei b/c i'ts cut broefe it nac ttw"au."flo..o lesat ti's eht nylo awy tihs asekm nesse +4
suckitnbme  I e.grea I inthk teh iustqneo smte si ysinga eth shcmaeysttip eewr eds.ioenl otN ttah htye rwee ared.sp +4


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