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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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tortAeilan of eht seirmtthtaoc set tnopi si a yiohlactphma erosspc addietme yb drlssaoaitnpng nad is tpendnindee of teh isyhpttaecm neursvo symest.

B, ,C ,D adn E lal eqierru syhcmtaietp neervs ot iilectl a sner.epos

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pg32  nCa onyaen naipexl the cimnhasem nhdeib svrniiegh dna teh citetyphsma enrsouv yem?sst +4
mdmikek89  ytaolahpsHmu aeslyr ohhrtgu hte noactmoiu urnsvoe e.smtys Yuo uct het lra,ye you cna nlyo nacheg teh httacerimtso ets iotp,n ubt eht ybod cn'at atrce. +1
umpalumpa  u,ysG I tkinh atht rfo teh hvngsriie ereatatnlvi eht tnpio is NTO taht tapiceyhmst esrnve oorcnlt nshveigir ,al(yatulc I t'aevhn ofund iaetclrs no dumpeb thta assy ttha ihrnvesig is onlreldcto yb aesht).iypctm THe sasiete ywa ot tnhki is thta hist tp hsa a temycsis toincfnei a(ak IRSscSms-yeti amiyframnlto eorsnpse rno.)meysd In I,RSS tp acn ahev 3l&;t5T C ro ;8&tg3 C, TBU it si erom noommc ot heav efvre ahnt yhempthr.oia iCdisnenorg htsi, yuo cna yeiasl ur-letuo eht reihsnvig aetlenarvt.i +1

Even brown fat needs SNS == release of NE == binds to beta 3 receptor on fat == uncoupling of ox phos!

+6/- apurva(101)


 +4  upvote downvote
submitted by โˆ—qfever(67)
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hlumHaastpyo tnrocinllog atemreetpru est poitn si ibeyrfl ntmieodne in aPmatho 0218 eidniot gaep 1,3 raphetC 2 III riCnalda nsisg of fnaoltiniamm D. vreFe

Peyesgon ;-gt& haopacgrme esleera 1LI- dan TFN g-;t& nacsederi gnaecsyylxcoeo ivaiytct in uhamhoaplyst araecrslvpiu lslec ;-g&t cirasedne souaaltmphyh PG2E ;-gt& reiasd martteepuer tes otnpi

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 +0  upvote downvote
submitted by gribear(0)
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aCn oneomse lixnepa hwy enhw you esntarct eth asplni rdco erorsupi ot eht lleev fo tpacesytihm ofwlout -- nad you tge a steiycms inecfniot -- het nopsrsee is tnolreaati of eht tttosecrhiam est tniop?

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its_raining_jimbos  So I coehs atth oen cueabse set tnipo si cnlortledo yb teh osthhylmaapu (PEG2 nda -I1L temaide veref in het pyhahoau)tslm adn eth rtes fo eht arwesn cshioce ivnldvoe nosmgheit bolwe eth evlle atht hsa nbee dnesact.rte Nto %001 user if tโ€™asht catcraue uoh.tgh +5
noselex  edrAge tihw ritgs_so@nn_miibjai -- eeFrv is aimdetde by lierntga est ptnio ni ymsal.phtahuo llA teh trohe s,oiecch sa raf as I nca ,tlle volnive ishcteytpam sveenr and ethri csfetef at rgttae rsgao.n +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)


 -1  upvote downvote
submitted by โˆ—j000(17)
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i gto sith iuqesnot gwr,on btu i hitkn hawt hsti estinoqu is lalery sakgni is htwa aenshpp ni a ssctymie icnfont:ei ihcwh si fever

in tiscmesy fic,einnto the somt booisvu gnsi to oolk rfo si a revef, nto eiarcsnelsy gir,ihsenv wiagen,st aeht dopnurotic by nrbow atf, tec.

dan owh soed revfe ucorc? keil eonsoem deayrla emedionnt: pyosgeen t-&;g- arosmagpche elraesnig IL1 nad NTF hicwh icssreean XOC ytvatici ni muhyltsaapho araclupseivr lcs,el neariesc iputrcondo fo 2EGP in smlhaptuaohy dan rsete teh eutrmraeetp set itopn.

i nithk teh lheow eahrps eop"lcmet toctsrainen fo eht plains cord pesoruir to the vlele fo pt.yci"eh.smta. si a rs.tiindtaoc ti sujt sletl uoy atth eoevtmneldp fo a erfev has hgontni ot do hitw ti

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j000  evetmpnledo fo a eervf ni emysistc ncetfiino hsa ognnhit ot od itwh saitteymhcp seounvr flo,w so veen st'i ienruj,d frvee louwd lsilt rcu.co I itknh hsti tsoienqu si sjut kganis owh dseo eefrv rccuo ni tomntfnimanf/ailonciie tnsio.uait +1
b1ackcoffee  So, ohw do oyu alixnpe eht uctaal rvfee by stuj annigchg eht ?mt?ohatrest erveF efftc''e IS ednru yaimStepcht lnt,ocro sjtu eht hgncnaig hte ttruemepera lik(e atmrsth)eto si deidtema yb cyisnekto dna h.phtluaamsoy +2
j000  ho i see twah you anme, lelw i dt'idn know t,tha so aksnht orf gnfylaiicr a.tth h,voerew daebs no yuro pna,txnieola ti oduwl stlil gte su ot eht ihgtr ranwes cwhih si aoitran"etl of tmtariohtsce ste "npoit, ont the fevre cetffe tlef.is +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)


 -1  upvote downvote
submitted by โˆ—mdmikek89(6)
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yOka boys nda glsir shti qiesotun si iserea htna uyo i.tnhk

amhaylHoputs ylsrea aiv hte ycattsimhpe uveosrn eymsst ot oocnltr eht byod wenh a wen ste inopt sa bene rhdeace in lste .saea.vyre...ufesc. c..fe..yiontb.in

If teh tncennocoi enebwet teh lamashotuphy adn nailps cdor anylm(i teh ysatmihtepc wuo)tfol si ,utc teh asmuahlt nnocta alrey hte body noetrcai fo a r,fvee tub hte aymsphtuloha siltfe cna lsilt genahc het set npo.ti

Boom

Wniiht hte b,nria the icmantuoo vuseron tymess si eragdeutl yb eth huathyaosl.mp mucAitnoo utocsnnif unilecd tloonrc fo rra,iopients rdiccaa rueotailgn eth( dacicar otcrnlo cr)en,et oosrvtoma itycitva (eth ovmrootas ecre)tn, nad rnecita lreexf taoscin hsuc sa ncgohi,gu nsi,genze slwolnigaw adn ig.ivmnto

-EB ruocc sa a resutl of a ahnegc in ste pnoti.

A neaspph ot eucsa the B-E wenh a wen ste ptoni is .heecrad

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In myciesst i,ticenonf lo'dwtnu uoy tge nuaeoscut ILaOvIAoDTNs i.e(. tesiutibdrvi ?sok)ch ihsT asw my eoigsnran rfo cinhsgoo )B ni hits aycwk sqiuet.no

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neilfespiritu  Sema +1



 -3  upvote downvote
submitted by โˆ—gh889(154)
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ormF keaSenuoyoHrnkodh on ierd:td

aWht eth ietousnq si ietgngt ta si the haytpsctmei ciahn wsa esp.dar tI swa a tlerbrie yaw fo dgniwor .it

oruY ietarorn uyhaapslomth si psleboeinrs ofr gclonoi tuersafe dna si nuerd yepitaaashptrmc crtn.olo A elosin loudw ceaus hr.pthmireyea

ourY etroopris hayautposmlh is selirospnbe fro tihaneg henw ero'yu dlco dna to teergane eht Freve srspeone nad is nuerd siapemtcyht nlt.ocor A sleoni lodwu ecusa eyahtrip.ohm

nI htis esuqtnio ti si ylmpis nagksi a persno gtse kcs,i lhysapomuath was aserd,p hwta eshpap.n

rsA:enw ythplhaasmuo lliw lstil eb aebl to etevael tes bdyo emuetratpre ot tatleb tfn.eincoi

H:tni IF ehyt giev a eiouqnst rsamlii to siht utb eodredrw ot dniulec a noseli fo het hyaitmsetpc sbfier ro of the hlsa,yopauthm you loduw in nrut TON be abel ot earenetg a eferv poesrens to .eofitinnc Teh ualypostamhh uldow eb irtlneye dreun ymiraetppsahcta orolcnt

sihT ddas remo otxetcn ot eht afct teh Q atsste ttha eht hcatymistpse aws apesrd

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oslerweberrendu  ,oS hsit sysa ttpscameihy osal edsarp adn laohshtypamu asol dp.aser Tehn wtha asw wrogn twhi shit icianlcl a?s?ec +1
adong  i tknhi the eatithspmyc sysetm si ltauyacl dameipri b/c 'sti cut oeefbr ti nac .ut."ot.owla"f esatl ist' eth only yaw tshi emkas ssnee +4
suckitnbme  I .gerae I inhkt teh sitnquoe stme is anigys het smcspttaieyh eewr enl.dieso Not taht hyte reew rade.sp +4



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