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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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aerotAltni fo eht ictotmharste set piotn is a phahctioamly ocpsers diaemted yb rplssgaitdnaon adn is ptidenneden fo the ctsymheapti rnueosv mtessy.

,B ,C ,D adn E lal iurqeer thcstypmaei svnree ot lileict a osespr.ne

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pg32  Can yoanen lniexap eth maneishcm dbeihn iisgvenrh nda hte ceiytmtpsha rusenov ys?esmt +4
mdmikek89  saymphHaotul yreals toguhrh teh ncatooumi sroevun ms.seyt oYu tcu teh ,alrye oyu nca ynlo aghcne eth sioetmrhttac tes ipont, btu hte bdyo cnta' ac.ret +1
umpalumpa  s,uGy I inhtk htat rfo het rviehsnig elvattnaier hte tnopi is NTO htta cimphteatsy evnres oclotrn risenihgv ,cylul(aat I hav'tne nuodf lcrtieas no mupedb ahtt yssa ahtt sirnigveh is toldcrnole by )a.cshempttiy TeH tisaese ayw ot nhkti si thta tsih tp has a ietssycm fntencioi aa(k emsSRi-stcISy latfynmamoir onsprese yenrds)mo. In S,RIS pt acn hvae &l3T5t; C ro &g8t3; C, UBT it is omer nmoomc ot ehav revfe than arhytimeh.po Cisdnegnori ih,st uoy can sielya ut-leuor het ihsgiernv e.vtinlteaar +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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uhtoapsalmyH icolnltrogn eeprearmttu tes ipnot is lbiyrfe neiedtomn in hmtaoaP 2018 idenito gepa ,13 ehatpCr 2 III aCndlria ssign of tmiaifoanlmn .D Fveer

egyosePn -&tg; hareampgco aereesl -IL1 nad TNF &-;gt indreeasc cglxoaeynycsoe aitiyctv in uahoytpshalm rlrupecasiva lscel -t;&g esrcneadi moauphhltsay PE2G t&-g; erdias tpeueartemr tse topni

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 +0  upvote downvote
submitted by gribear(0)
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aCn oenmeos lpiaxen ywh ehwn uyo acsrnett eht isnlpa odrc iueposrr to teh lleev of eishmcayptt twlufoo -- nad uyo etg a csimetys itcenfino -- the spsnroee is rolaietnat of eth tastohetcimr est tnpoi?

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its_raining_jimbos  oS I ecsho atht oen seacebu tse ponit si enldrotocl yb het ahtposyuhaml E2GP( and I1L- eatmide efevr ni eth y)haohltmspua dan teh etsr fo eth rweans ccheios odelvinv honmesgti owlbe teh elevl taht ahs eenb escet.tadrn Not %010 ersu if thtsโ€™a caacteru .hhgtuo +5
noselex  Agrede wiht brni_@siimg_aojtsni -- vreeF si amdidete by tiglnare set oitnp ni aump.yhtoslha lAl het rehto ,eioscch as far sa I anc ll,et ieolnvv eaiyshcttpm esrevn nda ireth efetfsc ta reatgt na.rgso +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 isth qtosiuen wgrno, btu i itknh hatw tsih iensoutq si llyrae asikng is thaw sapneph ni a ysestcim ifnct:eoin hwich si feerv

ni sysietmc eotninfic, het most voouisb gsin ot olok fro si a veer,f ont yescsenilar ,hngiivers e,sigtnaw ahet irodnuctpo yb wrbon ta,f c.et

nad who esdo eferv croc?u ikel mnesoeo ldreaay tomedin:en gnesyeop g&t;-- eosmharcapg aelsegirn 1IL adn NTF ihwch esiscnrea XCO atictviy ni mohlyhusapta raiavrecpusl ,lslce aencirse pcotrodniu of EG2P in losmuatphhay and seert teh uemaertetpr ste tin.po

i nhtik the wleho aphers eemtolpc" neitsrtacno of eth ipnasl codr purorise ot the lleev of thi"c.t.ye.spam is a noitiacrs.dt ti sutj etlsl oyu that elepdtomnve of a ferve hsa noghint ot od iwht it

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j000  edmtenpoelv of a ervfe in steycmsi tfocieinn sha nhonitg to do hitw ihtstyaempc oesvrun o,flw os enve it's u,enrdij rfeve uolwd illts cocur. I ntikh hsti nestoqiu si juts inasgk who seod fveer curoc ni ecaolimftiimtinnnnao/f anottusii. +1
b1ackcoffee  ,So who do ouy ipaxlen eht tlucaa eefvr by stuj iaggcnhn eht hse?tot?ratm evreF fe'ec'tf SI uerdn tcyipaetShm ocotnrl, stju het ianhngcg het raetemtperu k(ile sheamt)trto si atedeidm yb yesiktnco dan lh.aptmyoaush +2
j000  ho i ese wtha ouy mne,a ellw i nid'td ownk ta,ht so nsktha for iyracngilf a.tht eo,evwhr sdabe no oruy ,aapnteilnox it wldou tlsli etg us ot the hgtri nawesr cihwh si ltnaeoitr"a fo hcmtatetirso ste i,t"onp otn het rfeev eetcff fielts. +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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kyOa osyb dna gslir hits tiosuqen is eerisa htna yuo itknh.

aaHlysmophtu yarles vai eht pchitmayset veunors metyss ot lotncor het ydbo henw a nwe ets tionp sa ebne ardheec ni tles .a..ssrcvee.fuay.e. f..bnoyeti.n.ci.

fI eht nnenotcoic neeetbw het oauhlshmtpay adn ipsanl drco (lmiyna eht tamehyptisc ftlw)uoo is uct, hte shtaauml tocann leyar hte oybd aorncite of a rv,eef utb teh shpatlmyaohu etifls cna sillt henacg teh tes noip.t

Bmoo

niihWt eth rna,ib het oouaitnmc evrsoun etsysm is eradeltug yb eth pyslhaa.tohmu toomcunAi itfnnucos cndleui ctolrno of eirrnato,pis caidcar elaugriotn (het aidcrac oornclt t)nrec,e romtoosva iivyttca (teh rtaovomos )necre,t adn teiacrn rflexe nitsaoc hcsu as ciohugn,g zne,isgen oiwgwslnla nda vmgon.tii

BE- orucc as a tselur of a ganceh ni tes n.otpi

A sphpaen ot ucase hte -EB ewnh a wen tse ipotn is rechdae.

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI tsciesym ofeici,nnt ntolwud' oyu gte ucasuoetn ONTasvLIoIAD ie.(. dttivbreiusi ho)?cks ihTs asw ym negiaonrs ofr ncghsoio )B ni siht acwky tuioqesn.

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neilfespiritu  emSa +1



 -3  upvote downvote
submitted by โˆ—gh889(154)
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mrFo huyokeSHenkaodnor on tided:r

Wtha eth sntequoi si ggtiten at is eht teatsmcpihy ichna was r.psade tI wsa a eebrrtli way of wdgnrio t.i

Yuro reritoan osahyhmltpua is sienobpslre rof ocnglio rsatfuee and is rendu phcmaeyiarattsp lo.crotn A senloi ouwld escua hree.hapmyitr

Yuor rrotsiepo uyomhaalhtps si osrleneibps rof eniagth nwhe 'oeryu docl and to tgeaeern eht vrFee sneorsep dan is udenr stcihemyatp .crltoon A ilsoen dluwo ueacs eophrthym.ia

nI thsi toeunsiq it si milyps ksinga a nroeps steg i,kcs pythaauhlosm aws rsed,ap wtah napphs.e

n:wseAr hsytlupomaha wlli illst eb ebla ot eetelav set doby pmureetaert ot ealttb ci.feotinn

tH:ni FI hyte gvie a situoenq mialsir ot tshi btu owrdered ot elucidn a solnie of eth tpayemcsiht esirfb or fo eht t,mhsphouaaly yuo uowdl ni unrt ONT eb bael to teeeganr a vfeer rposenes ot eon.ctnifi The ualhphtsmyoa ouwdl be entlreiy enurd carhsmptytaepai tronlco

Tihs sadd omer tecntox ot het catf eth Q taests ttah eth setytmsaphci saw raespd

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oslerweberrendu  So, hsti sasy hmttisayepc loas aperds and tahluoaspmyh aosl asdr.ep eTnh htaw saw rgnwo twih stih alciicnl ?ceas? +1
adong  i ikhtn eth ipemashyctt smytse si alctyual dmaeipir c/b st'i cut oefbre ti nac .to".o.utl"faw ltesa it's hte onyl yaw sthi ekams eenss +4
suckitnbme  I .erega I tnihk hte osquetin mets si yansig eht tmtyechpaiss ewer ensedlo.i toN ttha eyht were sep.dra +4



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