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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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eoiltntraA of hte ormtietathsc ste ptoni is a pchalmihoyta rocsspe daeemdti yb iasltnrgpdsona and is neneidnpted fo hte stceapitmyh eosuvnr yemsts.

B, C, D, and E all euqerri tycphtisame enesrv ot ltecili a seo.espnr

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pg32  Cna onayen napxlie hte cnashmime ihdnbe igirenvsh adn hte etacsptymhi vneorus syset?m +4
mdmikek89  tpmahoasylHu lreasy ugohrth the tcoanouim snvroue s.ytsme uoY utc het ,yrlae ouy nca lnoy hecnag het troctamehtsi est ,piotn btu eht dyob ctn'a aretc. +1
umpalumpa  usy,G I inthk atht for eth iegishrnv aartetilevn het onpit is ONT thta stycemphiat nreevs lcnotro rhisenigv utyaa(l,cl I ntah've nfudo ltscriea no deumpb atth sasy tath rihsivneg is dlroentloc yb eyph)tmsai.tc eHT ssteiea wya to hntik si atht tsih tp ash a eiystcms ocifiennt aka( eitsI-SRmcySs raitmonyalmf pseonsre mndy)sreo. nI IRS,S pt nac vaeh 35lt;T& C ro g&;8t3 C, TBU it is meor nommco ot ahve vefre ahnt h.trpoyhaiem gserndCiion ht,is uyo acn ilseya to-rueul het seiivhgrn vnrete.iaatl +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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ouyspaHtamhl lgirctoolnn tuetpemrrea est tipno si rflbeyi meeitonnd ni aPoathm 2801 itidone pgae 3,1 atrephC 2 III iaadrnCl igsns fo niilmoatnmfa .D vreeF

egePyosn -;gt& omgephraca eslreae 1LI- dan NTF &-gt; iedcenars xygeoaoncelscy aytctiiv ni maasulohhpty ravciaerulps eclsl g-&t; eeisacrdn lmtpyahhuaos E2PG &tg;- diaers uerrpeamtte ste potni

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 +0  upvote downvote
submitted by gribear(0)
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nCa nsemooe laexipn why whne uyo ctrsetna teh isalnp dcro urposier ot eht evlle of eiahtptcsym otfoluw -- nad you teg a meystsic fcioentni -- hte oepesrns is raintoteal fo eth trcatthoimse est i?optn

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its_raining_jimbos  oS I hosec tath noe eaesucb ste potni is rltleoocdn yb eth lmsphhaotayu E(2PG nad -IL1 emteida ferve in the sahopmyu)ahlt dna teh tesr fo eth enwras eischco livondve itsegnhmo bleow the levle htta sha neeb dsatner.tce toN %100 uesr fi sโ€™htta atruceac hgothu. +5
noselex  eedgrA wtih _@ring_omajisbitnis -- vFeer is tieadmde yb lanirgte tes inpot ni suthpmaa.lhoy lAl hte hotre hocec,si sa arf sa I anc let,l vlnoive ychptieastm nervse dan hteir fsfctee ta atgtre gsn.aor +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 ihst qiseutno nrow,g but i itnkh atwh iths ieoqsutn si rlyael gksian si tawh nepahsp in a ecyssmit ife:icontn whhic si eferv

ni semitcsy otci,nnife het smot boosuvi nsig ot olko rof si a ,ervfe nto eryacselsin vseghiin,r i,nwastge aeht pdrtoouicn yb rownb at,f .tec

nad how dseo fvree ?rocuc klie omseeno ealaydr onetemndi: genpoeys -;g-t& msheoprcaag seeilarng LI1 dna NFT icwhh esierancs COX citvtaiy in aoahuylthmps aiverclrsuap e,sllc rcaeisen onocptidru fo 2EGP in ltsoahmahyup nda trsee eth mateurreetp tse .inpto

i ikhnt eht owhle sephar ocepte"ml oasircnentt of teh lnaspi cdro oiserrpu to eth velel fo cta.ypi"mhte.s. is a diicon.rttsa ti ujst ltlse ouy atht pdtlovmneee of a fveer ahs hgotnin ot do iwht ti

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j000  oetlmpdvene of a vefer ni icyssemt cinfitone hsa onhtngi ot do hwti mtsahcypite enuorvs lofw, so eenv is't r,enujid vefre lwodu isltl c.ucro I kinht htis netuqosi is tujs angsik woh deos efvre ccour ni ionnmtaimeffiltaon/cin onistt.iau +1
b1ackcoffee  oS, woh od uoy pxenial eht utalca veefr by sutj angchngi hte s??attrotemh reveF fecfte'' SI rednu Schtmeyapit o,rtolcn juts het anighngc eth tuatremeper (kiel ttoh)armtse is aitedmde yb niytcoeks dna a.spuamyhtloh +2
j000  oh i ese twah uyo aem,n llew i dti'dn nokw hta,t so katnhs rof ifinyagcrl aht.t hvero,ew dseba on ouyr oaianlxenpt, it dluow ltils get us ot eth ighrt nreswa hcihw si ani"laortet of tstraetoimch set "pitn,o otn teh evrfe ctfeef .stfeli +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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kOya bosy nda gilsr ihst ueoitsnq is eaeris htna uoy th.nik

mlohaatsypHu rlsyea iva eth thctesipyma orseuvn etssmy ot rlcootn eht body enhw a nwe ste piont sa eben ereahcd in elts vare..e..fc.yuseas. bnftc..oei..niy.

fI teh innnoectco neeetwb eht uomystplahha and spailn ocdr ia(lmny teh tptahmeiycs toufl)wo si ,tuc teh uahsmlta otcann yearl hte obdy oretainc fo a ,frvee btu hte myapalhhotus lfiset cna isltl hecnag eht set .nopti

Boom

Whtiin het ni,arb eth cunmtoiao nvrusoe tsymes is egldteuar by eth thayouhpls.am intucAoom uosincntf cnieuld tonlroc of ip,raresnoit aracdci tlgarnioeu t(he aardcci roocltn ce,r)ent vasootrmo iicvtayt h(te vaosomtro )tc,nree dan iranetc fxeler sanotic uchs as gohnig,cu eginzsne, nlswwoalig nda o.tvigimn

-EB ccruo sa a rtuesl of a ancghe in ste tni.op

A phspean to euacs eht EB- nhwe a new ets ipnot is e.ecahrd

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In citsmsye ,iotifnecn odn'wtlu yuo tge onueuatsc ONoDILvsATIa e..i( bitvuirsedti h?)coks sThi asw ym riognnase orf ocgihons B) ni isth cawyk o.qsitenu

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neilfespiritu  meaS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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moFr oerkdanoeShnuykHo no eitdd:r

atWh eht uqnteois is itneggt ta is hte isptachtyem ncaih saw rdapse. tI asw a teiblrer wya fo rowndgi .ti

uorY eraonitr slyhpohaamtu is erbeilnsspo orf colnogi taueesfr and is ndure tritpaacmpaseyh c.roltno A seionl uwldo eucsa ih.arehpteymr

ruoY oseporrti sypthahoualm is nesbiesplor orf gnhitea nehw eyruo' odlc dna ot gertneea hte vreFe penrsseo dan si edurn thcietapsmy ctolron. A elsoni oluwd eascu ptiyhrme.aoh

nI ihst itqsoneu ti is ipsylm gnskia a npsreo tges s,kic alhpstuymoah saw ,rdpeas thwa psnaphe.

wneAs:r ptymshalhauo lliw tlsil eb elab ot teevlea ets ybdo rutrpametee to baeltt icnit.feno

nHi:t IF eyth gevi a isteuonq rmaslii to isth tub ddrweore to nludeci a ilones fo eht tahcpimtsye rsbife or of the l,htyamhspuao oyu owdul in rntu TNO eb blae to gnraeete a evfre snpreoes ot t.cenniofi eTh ophlsthamuay dwulo be irelenty rndue reaimpycstaphat roctnlo

hTis dads emro etoxtcn to teh ctfa eht Q tatses ahtt eth mhyitassctep swa radspe

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oslerweberrendu  oS, tihs sasy eyiatshpcmt laso saderp nda yhuslmpoaaht olsa d.rpsae eThn awth wsa wngor wtih ihst iincalcl ae??cs +1
adong  i inhkt het eptsmyatcih tesysm is cyutalal mirpedai /cb its' tuc beoerf ti nac f..ta.tlouw"o" etsla i'st het lnoy way htis askem sesen +4
suckitnbme  I ee.rga I khnti het eotqsnui tesm si sngiay eht saciteysmpth erwe ine.lodes otN htta heyt ewre ersp.ad +4


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