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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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Aetntioral fo hte irhtetacsotm set itnop is a yahmhailptoc rspeosc edmteaid yb olpstsgaarnind and is denedtinnep of the tpycmsehita roesnvu mtessy.

B, C, D, nad E lal rueieqr tsyemptihca resven to ltcleii a so.eespnr

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pg32  Cna yaneno pelniax teh misheancm iebhnd ghsirnive dna het psamteyhtic evusrno m?syste +4
mdmikek89  lHhypuamtoas srlaey huthrgo teh ocnamuiot novsrue e.systm uoY tcu eth aeyl,r yuo acn lyon heacgn eht tihctatmeros ste intp,o btu eth ybod ncta' rteca. +1
umpalumpa  su,yG I kinht htat ofr het nhesivirg ireltenavta the inopt is NOT ahtt cttphmiseay nveser crolotn rieishgvn u,(alcltay I nv'eath nfuod astclire on mpuebd ttha sasy ttha rgsehniiv is onreodctll by sephcmti.)tay HeT tesisea ayw ot ktnhi si ahtt isth tp sha a tismescy oefitcnin a(ka steicSmSI-ysR mroaanytfmil rneospse .)moryedns In S,ISR pt nac aehv l53Tt&; C or 3t&;g8 C, BUT ti is roem nmcomo to hvea feevr tnha yeati.hphorm rnCodsngeii ihst, uyo can ielasy rut-loue teh inhersigv al.etriaevtn +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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tuahmoayspHl ollcrnotign turmeapeter tes tpion is eylfibr teienmnod in hmaPaot 0128 ndietio pega 1,3 Crhptae 2 III ilCraand gsins of mfiioaanmntl D. eFver

enPgyose -&g;t aracoehpmg rleeaes 1IL- adn TNF &;g-t acednersi gaeycocloesynx tiviatyc in alsmatophhuy iaraurpvcels elcsl &;t-g siendecar pyashmuhaotl 2PEG -t;g& sirdea uatrmetepre tse tinpo

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 +0  upvote downvote
submitted by gribear(0)
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aCn eomnose ilexpna yhw hwne oyu tarscent hte iplans crdo rpuoseir to het elelv of cphtiaeystm uwoloft -- and yuo etg a ciymtess enntioifc -- eth rseposen si arltnieoat of hte thsaeciromtt est nipt?o

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its_raining_jimbos  So I ecsoh atht noe eusbeca ste iontp si lncldotore yb eth uthlmasaphoy EG(2P nad -1IL aedietm ervef in hte ap)oaumylhsth dan the etrs of eth nersaw hciecso vliovedn gmtosinhe oelbw eht evlle thta ash enbe .dcettnarse Not 010% eurs fi tโ€™thas tcuceaar ughh.ot +5
noselex  ergAde wthi iisba@_gsjriomnnt_i -- eervF si eadmedti yb itnagrle ste itpon in osphlhuayam.t llA eht eohrt chcso,ei as far as I cna tll,e liovenv phmicsyaett nvrsee and their eeftfsc at rtagte so.narg +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 siht qitsneou wo,rng but i htkni awth thsi equtinso si yrlale anigks si twha saepphn ni a csyemsit ni:otenifc hwhic is vfeer

ni smectysi niiofn,etc eth somt uvoibos gsni ot ookl ofr si a ,efrev nto ryeliscsean esnvg,ihir nitgaws,e eath optuncdrio yb onwbr ta,f et.c

dan woh deos reevf ?rcuco lkie eoomsne yldaare inodt:neem gpeyneos tg-&-; rapshmcgaeo ngelsaeri IL1 adn TNF hchwi cesaerins OCX ttiiycva ni poystauhlhma rieuvpsacalr elcl,s rcesaein tunopocrdi of EPG2 in asylmaouhpht dan retse eht uaetrmetrep est t.pion

i tkihn eth eowlh prseah ceo"etmlp treaosincnt of het anlsip dcor oersuipr ot teh levle fo ..ty"stahpi.emc si a i.ttronscdai ti juts stell oyu atht pdlnmoeetve fo a vefre has nnhgoti to do tihw ti

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j000  tedelponemv of a freve ni tyemciss ocennifit ash hiongtn to do wthi hmcestapiyt ounsver lfow, so neev sit' rjinu,de fever wuold tllsi .cucor I tnkih hsit uqostnei is jstu sgnaki woh sode erefv rucco in ti/fnaofaimnonltiemcni ttnuiis.oa +1
b1ackcoffee  So, ohw do ouy lixnape the cutaal eevrf yb tujs ngihganc teh etstrhatm??o rFvee 'ec'teff SI rneud yiaSttphecm rocnot,l jtus het ighcngna hte mptrrteeaue lkie( shattoermt) is mieetdad by tieocnyks adn posa.hmltyhua +2
j000  ho i see waht you a,enm lewl i 'nddit know ,thta os nhstka ofr ylriiancgf that. w,ovhree adebs on ryou ntpaoile,axn it wludo lstil gte su ot teh ghtir eswran ichwh si etlati"noar of istathrotemc set "ipno,t otn eth evefr fcteef s.felti +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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aOyk bosy adn lgrsi shit uetqison si esreai hatn yuo kinth.

haptuHyamslo lysrae aiv hte pytsthicaem onvseru setsmy to nlrtooc eth yobd ewnh a nwe tes iptno sa bene aceehrd in stle .aeycf.es.r.su..vea o.i.eintnb...cfy

If het ncnooteinc neewteb hte ltaaoymhsuhp adn islapn odcr (limnya the pyhmtastcei loft)owu si t,uc hte mautaslh antnoc lyrea the yobd treoaicn of a everf, ubt eht pohsaauhtylm ieltsf nac illts angehc the set toi.np

Bomo

tWnhii hte naibr, the cinoomatu orsnvue etyssm si eeaugrdlt yb het tmouyshal.hap oiAtumocn ontfcisnu dlnuice tlonroc fo tpniori,sear aradicc oirnteugla eth( daaccir ltcrono c,etne)r stooovmra yiitactv (eth ootsavrom rc)neet, adn ntireac erflxe ctanois chus sa ihnugco,g genisn,ze gaonlwslwi dna .mgtovini

-BE crouc sa a lstrue of a hngcae in ets np.oit

A spphaen to easuc the B-E wenh a ewn est pntoi is daecreh.

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI ectiymss tncoien,fi tunw'odl uoy tge cnueotsua NITOvaosDLIA e..(i uistirvtdbie )?kosch hTsi was ym onrsgaien fro iosconhg )B in hits kwyca enos.tuiq

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neilfespiritu  eamS +1



 -3  upvote downvote
submitted by โˆ—gh889(154)
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roFm dokuSaenokHyhrneo on dt:rdie

htWa hte uisnoteq si ntgtgie ta is eth styhpitecma achni aws sra.edp tI swa a beleritr yaw fo onrgdwi ti.

ruYo trnaerio moluthphayas is eesliopbsnr for lncoogi afsturee and si edrnu aippecsytaarhtm rocn.lto A elnios wluod asuec mieypaterrh.h

rYou trispeoor oahlysatupmh is isbrsneeolp orf hitaegn hewn yroue' docl adn to eatnegre eth veFre neeosrsp nda is drenu yhtetsapmci c.olrton A enlois oluwd acues a.phemyhoitr

nI tish uoisnteq it is ylmips iankgs a psnore stge ,iskc uaptmyohlhas asw ,redpas hwta spnp.eah

nerA:ws mylhasahoput lwli iltls eb bela ot teaevle ets byod reepateutmr ot atlteb ifoectn.in

:nitH FI htey vegi a qinutseo amlrsii to tihs ubt drrdowee to dulecin a losien of teh ptamiectyhs sbirfe ro of eth ,shlamhapyuot uyo duwlo in nrut OTN eb labe ot gtreenae a reevf srpseone ot f.cinneiot ehT uptlyaamsohh ouwdl eb eyrtniel reund ahtpermisaatpcy onclrot

ihTs dads remo otncext ot eht fcta het Q asttse hatt teh tsshmayiepct was ardeps

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oslerweberrendu  S,o hist syas tyapchmiste sloa edspra adn mhohlsautypa aosl prde.as Thne thaw saw rnowg ihwt iths clincial a?ces? +1
adong  i knith eth haiptctymse mtessy is uctlaayl epaimidr bc/ tsi' ctu eorbfe it acn ".atwutoo.f"l. satel its' teh oyln wya iths maeks nesse +4
suckitnbme  I a.eerg I ihknt teh euqinots stme si nigays teh ttsiamcsyehp ewre ee.isdoln toN atth etyh weer pdsae.r +4



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