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Retired NBME 21 Answers

nbme21/Block 2/Question#40 (reveal difficulty score)
Acetaminophen and nonsteroidal ...
Prostaglandin E2 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: MEM Pharm Prostaglandins

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 +29  upvote downvote
submitted by โˆ—acanthosisnegrocans(29)
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In the great words of Dr Sattar:

"Prostaglandin E2 mediates feeeeeeeeeever"

NSAIDs --> block prostaglandin syn

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thisisfine   This is all I heard in my head +9
temmy  Me it was so weird +
peridot  I do want to add, that while PGE2 is the right answer, FA19 p.213 says that IL-1 and TNF are involved as well. However, because the question asks about what is going on in the hypothalamus, the answer is PGE2. If the question had been asking about what the macrophages were releasing to influence the hypothalamus, then the answer would have been IL-1 or TNF (FA didn't specify if it was TNF-a though...). +4
feeeeeever  You know why I'm here +12
magneto  To add to @peridot, IL-1 acts on the anterior hypothalamus to increase local production of PGE2, which in turn will induce fever (PGE2 increase the set-point temperature) +2



 +5  upvote downvote
submitted by โˆ—temmy(153)
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Almost failed this question but i kept hearing Dr Sattar screaming prostaglandin E2 FEEEEEEEVER

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 +2  upvote downvote
submitted by โˆ—an_improved_me(91)
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Question: based on what we know about the hypothalamic nuclei, would the effect mostly be ont he posterior or anterior nuclei?

Posterior = Heating, so is it being stimulated? Anterior = Cooling, so is it being inhibited?

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 +1  upvote downvote
submitted by aishu007(4)
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Elevations in body temperature occur when concentrations of prostaglandin E(2) (PGE(2)) increase within certain areas of the brain.These elevations alter the firing rate of neurons that control thermoregulation in the hypothalamus.. It is now clear that most antipyretics work by inhibiting the enzyme cyclooxygenase and reducing the levels of PGE(2) within the hypothalamus.

https://www.ncbi.nlm.nih.gov/pubmed/11566461

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yotsubato  Ugh, again a concept NOT in UFAP anywhere. Bites me in the ass every time +12
epr94  pg213 FA2019 +8
ali_hassan  FA 2018 pg. 211 +



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