NBME 22 Alteration of the thermostatic set point (NBME Answers)

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 🔍 / 📺 / 🌳 / 📖
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+20 upvote downvote
submitted by ∗keycompany(351)

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irltatneAo of eth thtarsmctieo tse pntio is a hayclhtapoim orcsspe mtiededa yb gnlsntaadpriso nda is ndetednpein fo the stptiycahme nresvuo etmssy.

,B C, D, adn E all eirrque acethmyitps rvesen ot iilcelt a e.nserspo

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pg32 aCn aonnye iexlnpa hte mismanche nhedib irsievngh nad het piymhteatsc vnoerus e?tmsys +4

mdmikek89 olaspyahutmH ylares rhgutoh hte aocimonut ruvnoes t.mseys uYo tcu eth eyra,l ouy nac only hnceag teh ttatheoicrsm ets ,point tbu het yobd nact' ter.ac +1

umpalumpa sGu,y I ntikh hatt fro teh grinehvsi erattvinlea the tiopn si ONT atht hipastmecty rnseve oocntlr nisgrvhei (cltayla,u I aet'nvh nfoud cleitars no dubpme htta yass tath nsihgevir is lednctolro yb ticayhpemst.) eHT eieasst way ot intkh is htat isth tp has a eymissct nnifoicte (aka eSsRym-icSIts tmylmrifanoa ensoespr dsen)ro.my nI IR,SS pt nac vhae t5T3l;& C ro &tg8;3 C, BUT it si oerm omnmoc ot ehav erefv ahtn iahyrpthm.eo nodCiinrseg si,th oyu anc aeiyls rtu-eoul eth egirsnvhi vrl.eeaitnta +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 ∗qfever(67)

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uholtsyaapmH roilnclognt earpuemetrt tse ioptn is bfrleiy dtnmeieon ni aomPaht 8201 diointe geap 13, parhetC 2 III dalnarCi gsnsi of mmniaaniflto D. rFeve

gyPsonee gt-;& ermpaghoca leersea LI1- dna TFN ;gt&- ceinsrdae clocgxyosaeyen aittivyc in uahhytoapmsl raperlusavci llesc ;tg&- esrcdeian oaathmyhlups PEG2 g&t;- aiserd rtmeetearup est ntoip

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+0 upvote downvote
submitted by gribear(0)

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aCn emosnoe npilaex wyh whne oyu enrsactt eht snilpa dorc rousiper to eht elelv of ypiastmecht lwtuoof -- and uyo gte a issycmte inntefcio -- teh sersonpe si telantiaor fo the hrsoettamtci ste ?itnpo

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its_raining_jimbos oS I seoch tath oen ceeusab set ontpi is cnroetllod yb the oamhaptsulhy (G2EP and 1-LI eatemid eevrf in eth uhs)aohtmlypa and the tres fo het nrasew eocihcs vdilonev tigenhosm elbwo hte vllee htta hsa enbe aettrsdec.n otN %100 urse if t’asth uecactar .huthog +5

noselex Agered htwi rimionjis@gni_abst_ -- Frvee si mdiaeedt by nraeitlg ste nitpo ni ayumpohhs.atl All eht toehr hc,eciso as afr as I cna e,tll lvenvio pmyhtsaceit serven adn ihetr fectfes ta etgrta no.srga +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 ∗j000(17)

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i otg tish enutqois r,gwno btu i kthin awth itsh oisutneq si really kagsin si twha nehsppa in a timscesy ftcionne:i cwhih is efvre

ni cmiytses ,ninetiocf eth most vuiboso igns to loko rfo si a fvree, ont eyiasserncl ,rhevignis egits,wna hate nuiprtoocd by rbwon atf, et.c

dan woh sdoe efvre orccu? like neoomes eyalrad eotemn:dni neespogy -g;t&- hsmcoepraag rlgeaseni 1LI nad NTF hhcwi rnsceaeis COX iiatytcv ni phyhsolautam pcualiaerrsv ,cslel easrienc dnotpcuiro of G2EP in ohmhaaystulp and erest eth etrtmepruea set io.ntp

i tikhn teh oehlw arepsh pmtel"ceo ntsnroiaect of hte ilsnap odrc uriosrep ot het leevl fo "msicy...httape is a ttirsnidoa.c ti utsj tllse uyo htta dnlpovmetee of a vfere sha tghnion ot od with it

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j000 dtvmeepoeln of a erefv in imscetsy eicfntnoi sah itnghon to do thwi tyamecstiph evnorsu ofl,w os vnee i'st irud,jen vfere luwdo ltsli ourc.c I nkiht stih qsotneui si tusj kiangs owh odes erefv cucro ni necnaf/oilftoamintiinm istotnaiu. +1

b1ackcoffee oS, how od uoy xpaenil teh atluac ervfe by tsju nhggican eth aho?etmr?tst eevFr fcetf''e SI redun iSmcayetpth lotoncr, tujs hte gcginnha the purrmteeeta k(lie trea)sohttm si metideda yb ystkecnoi and hsaputmo.lhay +2

j000 ho i ese htaw uyo am,en wlel i dditn' konw ttha, os sankht for yarlicnigf a.tth rvhwo,ee dbaes on ryou ,lopxinnaeta ti lwuod tsill tge su ot hte ghrti erawns wichh si tlo"nraetia fo haimrsocttte set ",point tno hte vefre efctfe iel.fts +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 ∗mdmikek89(6)

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kyOa osby nad glsri siht seutionq is iesrae htan uyo n.kthi

lyaosmhpautH alysre iva het itsaytpemch vuosren ssmtey ot tonrlco the yobd ewnh a ewn est ipont as nebe aehcred in tels re.ves.f.aue.asc..y ..ny.icfbiet.o.n

If eht innetncooc wenbeet hte mypsoalahhut nda plisan orcd (maliyn eht typtsehicam ou)fwlot si ct,u the uhltsmaa nancto aelyr hte doby nietacro fo a fevre, tbu hte ayhuaposthlm lsteif nca slilt hcgean teh set ptio.n

mooB

Wihint het bn,ira het amuoonict evnuros tsmsey si ltrueeadg yb the mayotsahplh.u noucomtiA tofnsciun cdeunli notcrol fo istep,rorian crciada touglnarei e(ht acicdra nootlrc ,ceetn)r rvtmosoao attcyvii t(eh rmoaosvto n,crt)ee nda irectna xlfeer ocstani husc sa ocni,ghug i,genesnz lloniwwags and nmovig.ti

-BE crocu sa a rstelu fo a gecnha in ets .nopti

A pehpnsa ot auecs teh -BE nehw a wne est ipnto si arc.ehed

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-1 upvote downvote
submitted by ∗isaacyo94(13)

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nI ticssyme tcnonif,ie nu'wdlto uoy tge satcuueon DIIosAaNOLvT i.(.e dsvtibeituri k?hc)so sihT swa my srneangio fro hiocsogn B) in hits ckayw en.iqosut

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neilfespiritu meSa +1

-3 upvote downvote
submitted by ∗gh889(154)

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orFm kSoynderHokounhea no rde:dti

thaW eht tisnqeou si etiggnt at is het hiametysctp incha swa s.drpae tI aws a iblerert awy of gwdorni .it

ouYr tnieroar topsuylhaahm is nlepsbriseo ofr lnooigc aurtfese adn is enudr pypimtearschata lon.crto A oseinl odwlu eacus .yehmritphrea

Yuro eriopotsr myhasuptolha si rpoenlsiebs fro thageni hwen oer'uy lcod nad to enrtegae the vrFee ornepsse dan si rneud aiehmtsytcp oro.ltcn A oiensl owudl ucsea mtyeaiphhro.

In hist tenqusoi it si mspily isankg a snpreo gets kisc, husyapthloma aws drasp,e hwat ph.panse

:nwrsAe auotyhspamlh wlil sltil eb leab ot teevael tse bdoy taueterrpme to ttaleb oifn.ictne

ti:Hn FI etyh ivge a noqtiues msiirla ot tsih tbu odrwreed ot ciduenl a neslio fo hte stetimcpyha sbfrei ro fo hte ,aasuothymlhp oyu wdolu ni rnut TON eb abel to aregtnee a vrefe pseonsre to tfnoie.cin heT umtholyaahsp uwdol be itleryen denur paraeytpsahitcm ocroltn

ihsT ddsa erom otnctex to eth tacf het Q tsaste htta eth eapisytshtcm swa aerspd

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oslerweberrendu So, itsh assy hesypmtaitc slao perdas nda hyaplstamuoh also dsear.p nhTe waht was nwogr htwi isth lcnlicia ae??sc +1

adong i nikht the tmtpyahcsie stesmy is cltlayau iipeardm /cb i'st tuc efbero ti anc w"utlo"oa.t..f eatsl ist' the lyon awy ihts eskam ssnee +4

suckitnbme I rea.eg I nthki eht ueqitnos stme is ygansi hte ithspetymsac rewe dleo.neis oNt ahtt they reew r.dpesa +4

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