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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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aitrneAotl of eht ethmoitsract ets iotnp is a hiohamytpcla epsorsc edmaedti by pannigsltarsod adn is entdnpniede fo teh tmiypheatcs uvrosne smyste.

B, C, ,D dna E all eiqrure miesapttyhc srnvee ot iitlecl a noerss.ep

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pg32  Cna noenya laxiepn eth nmmeaisch hnedib gvesinhir dan the scptemiayth sneourv tss?mey +4
mdmikek89  Htmuaplosyah lyreas uohthgr the miuotaonc eournsv ymtes.s You utc eth ,aryel uyo cna nylo ngceha teh omtsrtaichte tes itnp,o tbu hte dboy ntc'a .etrac +1
umpalumpa  sGyu, I kniht taht rof the ngvhiseir elaietavtrn the notip si ONT taht cytmahstipe esenvr olornct ivinsrgeh lau,tc(lya I tev'han dufon rtiascel no pdmbue tath ysas tath ihnvsgrei is crlnoloedt yb icm.t)yasehpt TeH aetessi way ot hkint si ttah siht pt ahs a cetssymi eoicnnift ka(a istceRISsS-ym ralyonimtamf pnsorsee rsdm.)yone In ,ISRS pt can veha ;ltT3&5 C ro t&g3;8 C, TUB it si omer commno ot evha ferve nhat otihep.mhray rienngCsodi th,si uyo cna liayse l-uroteu hte rhvgiines t.avenalteri +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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pumsyahltoHa ilcgrnoontl martrutpeee est pinto is rfibeyl ntndeiemo ni mthaoPa 1208 ieitdno gaep ,31 eCathrp 2 III Clrdinaa ssign fo mmoainliftan D. everF

ysgePneo -t;g& hpecraaogm ereslea -L1I dna TNF &g;-t aecidrnse ycyoageecnslxo yaiivtct in hplmoytuaash cviresplraau llcse ;&t-g icesreand mahstuypaohl 2EGP t;-g& eardis raetemrpetu ets opnit

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 +0  upvote downvote
submitted by gribear(0)
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Can eomesno ielpnxa ywh nhwe oyu tescntar teh lipans dcro reuopsir to eht lleev fo chityemptas foowult -- and ouy get a tisycmes cionefint -- hte nreseosp si aetlrtnioa of eht tctstomriaeh tes pt?nio

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its_raining_jimbos  oS I eshoc tath oen baseuec set topni si ltocdlneor by the tymaphsuloha GE(2P dan I-L1 meetadi rvefe ni teh hlytoahsma)up nad het rset of the reasnw hescioc edvvlnio neshgmoit obwle the veell htta sha eneb sratetenc.d otN %001 uers fi โ€™sttah tuaecacr gh.huto +5
noselex  egerdA wiht ibaj_s_isomi@nigntr -- evrFe si iedtamde by tgenrail set tinpo in aa.suohmptlyh All eth oehtr ,scihcoe sa fra as I cna ,tlel iovvenl iahmcepystt venesr dan ireht ftfseec ta egratt argons. +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 got iths sioquten g,nwro tbu i iknht whta sith oisntuqe si ylelar aknsgi si hwat sanhpep in a eiysscmt encin:ifto chhiw si erevf

ni itsmsyce fotcini,ne the mtso ovbuios nsig to ookl ofr is a verf,e tno ecasnsliyer nhrsieivg, netgaw,si htea iuoctrndop by wborn ,fta .tce

nda owh edos vfeer occr?u iekl eomnose lraeyad t:nonmeied gpyneseo t;-g-& geoachpsmar sgeaeilrn L1I nad FNT hhwic recsnesai CXO aicvtity ni moaahhspulty saelvicaprru lcels, rnecsiea opitrodunc of P2EG ni saoplhhyaumt and teers eht emaeprruett set ionpt.

i ithnk the elowh separh mle"tepco ecatirsnnto fo eht iaspnl rdco puesrori ot eth leelv of ecaytth."msp..i si a ianstro.dcti ti tsuj tells oyu hatt vteleeomdnp of a ferve sah ognthin ot do wiht it

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j000  teepdeolnmv of a eefrv ni itsscyem oenfnitic ash ighntno ot do ihwt hmaeyicttps sveourn owl,f os eenv t'si uerj,din erfev luodw lsilt ccu.or I tnihk tshi qisueotn is sjut sagkin woh seod efevr ccour ni io/aictaltfminnnifemon t.otansiiu +1
b1ackcoffee  S,o who od uoy lepainx teh laucta erfev yb tusj ngcghnia the tmtteh??oras eerFv fet''cef SI unrde pttmhaeyiSc rtl,noco usjt eht nihggacn the meueeparttr (elki )amhrttotes si emdtidae by nsceyktio nda sypho.ahtaulm +2
j000  oh i see wtha yuo ,neam wlle i ndtd'i wnok atth, os satkhn fro ncliyarfgi .htta eer,ohwv dabes no yruo etnlnaoiap,x ti duolw litsl teg su ot eth gtrih nrsawe hwchi is rtlein"aaot fo ahctseirtmto tes "it,opn nto eth fvree ffeetc tfes.li +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  upvote downvote
submitted by โˆ—mdmikek89(6)
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Okay yosb and rslgi shit otneiqsu si arseie tnha oyu nhk.ti

atmlHhpoyaus aerysl iva het cthsmayietp uvonres setysm ot trloonc eth bdoy enwh a new ste iptno sa enbe adrehec ni lste svacf.es.uera.y...e .bei..nyfn..octi

fI hte eocicotnnn tewbene teh mpysahualtho and ilpsan crod nai(ylm the iehtacytpsm fwo)oult si uct, the lahsuatm acnnto ayerl eht obdy iracetno fo a ervf,e utb teh oaplthhausmy setfli nac illst ehacgn eth tse i.otpn

mooB

hnitWi het anb,ir hte uaocimnot suvoner ytemss is lartgudee by het h.paaylhmoust icmouAton niutocnsf ldencui rlootnc fo r,ioestrpnai aicdacr ngilueraot (teh rcacaid tconlor rt,en)ce soromoatv yvattici he(t rmtosaoov tcene,r) and icaernt elrfxe saoitcn hucs as og,hunicg seg,znnie lwwlaniosg nad mtviig.no

-EB crouc as a sturel fo a gahecn in tes pn.oit

A ephpans ot eucsa teh E-B ehnw a nwe est pniot si eae.dhcr

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI msieystc nietnic,of ndlowt'u uoy egt seacuuton oaLIAOITNsDv ..ei( iuisbdittvre s)hokc? hiTs saw my seigrnona for ogoihscn )B ni this cyakw .uineostq

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neilfespiritu  ameS +1



 -3  upvote downvote
submitted by โˆ—gh889(154)
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Frmo udHSonehrkoyakone no :dditre

htWa eht qntiueos si ngegtti at is teh itehptsmcya chian was spa.rde tI aws a letiberr awy fo wirdogn i.t

uroY antirore sopaltamhhuy si leoersinbsp rfo gcoioln freutase dan si dunre hcaaesaymrtptip clnt.roo A lnieos ldwou secua rapiethe.rhmy

uorY rioetpsro mpluhahoyast si broeplnises for hateign whne ru'oye olcd adn to terneega teh ereFv neorsspe adn si runde pitcthaymes on.rotcl A enoils wodul seuac eirpm.tohyha

nI ihst eitqnsou it si ispmly ikagns a nosepr tsge ,sick patsalomuhyh asw aps,dre wtah hpnpse.a

enAs:rw alompuyashth lilw lstil be aebl ot atvelee tes ydbo metupterera to tbtael c.etnfnioi

inH:t FI yteh eigv a utqisoen rsilmai ot tish tub edorrdwe to cunelid a isnelo fo eth amitshpceyt biesfr or of het yhhluotaa,msp you lwduo ni rtun NOT be abel to rtaeegne a vefer rsesonep to in.oeintfc eTh spmlhtyhauoa uowld be tlryniee neudr tmasipphaatrecy rtncool

sihT dasd rmoe xncteto ot teh tfac het Q aesstt thta the isscyttphmae swa esrpad

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oslerweberrendu  o,S ihts says ipmceyttsah olsa seapdr dan tspyuahlomah osal sdprae. heTn awht swa gwron hwit htis nicaicll ?ae?sc +1
adong  i ktnih eht eptctayhism ymstes is lulcatay emadriip bc/ ti's cut eebfor it nca talfo..o"u"w.t tlesa sit' hte lnyo wya htis kmsea essne +4
suckitnbme  I eeagr. I ihntk eht eitqsnou estm si nsygai eth ptysehmcsiat rwee .neloedsi Not atht ehyt erew s.apdre +4



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