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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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eltAitrano fo eth oimrehttcats ste opitn si a oalhimacpthy epsscor tdeiadme by donlaigrpstasn dan si ndineedetnp of hte emctytaspih veousrn ymstse.

,B C, ,D dna E all reqerui aeshmtctipy esvenr ot lcliite a ns.peosre

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pg32  naC yneoan xapneil teh csihanmme enhdbi iesvirgnh nad eth sycteahtipm suvrneo ?yemsts +4
mdmikek89  almyoHshautp ysrlea ohgtrhu eht uomcoiant ovsneur my.sset ouY utc hte ,ralye ouy acn ynlo cenhga het tttirhcmeaso ste noipt, utb hte doyb tac'n ra.tce +1
umpalumpa  ,sGuy I ikthn atht rfo eht enhgviirs airlavttene the ponit si TNO taht emthtscaiyp evnres ootnrcl ehingrvsi ,tul(aaylc I ante'vh odfnu serlitca no emdupb taht ssya that visrnehig is oedloncltr yb .acphte)ytims eTH isestae yaw to inkht si htat thsi tp hsa a tcmysise niicenfot (kaa sSmtSiIce-syR naimmalrfoty orpsnsee n)rdoy.sme In ,IRSS tp nca vhea 3tlT&;5 C ro 3&8;gt C, UTB it si erom mnmcoo ot vhea veref nhta ytrpha.eoimh goCersinnid shit, uyo can siyael uer-lotu hte eihngvsri retine.alvta +1

Even brown fat needs SNS == release of NE == binds to beta 3 receptor on fat == uncoupling of ox phos!

+6/- apurva(101)

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 +4  upvote downvote
submitted by โˆ—qfever(67)
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auyoptmaHhsl nircnolotlg uepmaeerrtt tse otpin is byfirel inedtnmoe ni oPhaamt 0281 idteoni epga ,13 aertphC 2 III raniClda ssgni of fionmnlamati .D vreFe

goyesPne t;g-& pagcmoarhe seeelra 1LI- adn TNF ;t-g& eeicadsnr aoyxeclngysceo atiytvci in saatypmhluoh rcsalvepirau leslc ;-t&g reiescnad hauahmylspot P2EG gt-&; erasdi auteeptmrer ste onipt

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 +0  upvote downvote
submitted by gribear(0)
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Cna enmesoo npixlae yhw when uoy tanrcets hte inpsla docr rsruipeo to eht eellv fo isycetthmpa ofltuwo -- nad ouy etg a secmyist nfcnoitie -- hte sperseon si rletaaniot of eth caittsoehrtm tes ?inpot

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its_raining_jimbos  So I oesch hatt neo bcasuee ste nitpo si cntlolrdoe by the sytomlaauhph (GEP2 nda L-I1 teadime frvee in eht toluh)pashmya dna eht etsr fo eth naserw cehicso dvoeivnl shgoetnim ewolb hte lveel htta ash eben tcer.danest Nto %100 esru fi asโ€™tht trueaacc gt.hohu +5
noselex  gAered whti mbin_t_onajrsi@isgi -- rFeve si etmdiead yb lgrienat tes pnoti in olyahtuh.masp lAl teh toher ico,cshe sa arf as I nca lle,t elvionv empthacstiy enrevs nda ehtri fesefct at geratt grsn.oa +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)

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 -1  upvote downvote
submitted by โˆ—j000(17)
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i tog ihts unqtoies rwo,ng tub i hnkit awth hist tueisqon si lrylae isagkn is atwh eapnpsh in a sesicymt iencfit:no ciwhh is erefv

in stsyicme noec,nitfi het otms buoisov gnsi ot kool rfo si a ferve, ont ysclieaensr h,iisgenrv aew,tinsg heat rnoiuodtpc by wnrbo tf,a tce.

and ohw sdoe efrev oucrc? ikle oneoesm aedyrla :etdonmnei egoeynps -;-&tg acghspromae eeigasnlr L1I nad FNT hihcw csesnreia XCO icatvtiy in ahomlyathsup ireuslpcrvaa s,clel isenaecr noicrdoupt fo GP2E in houpaaltsyhm nad seter eht eteepuramtr set tpi.on

i hkitn hte eohlw rashpe pce"ltoem tecasrtonni fo hte lasinp rcod pisrouer ot the vllee of c"i.aptyets..mh is a .iratdsnoitc ti ujts etlsl yuo htat nelevedtmpo of a rfeve sha ogitnnh ot od whti it

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j000  dpelmneetov fo a revef ni sisemtyc feiinntco sah nhontgi ot od ihtw etcmythpisa evonrus oflw, os eenv 'tsi urejidn, rvefe duowl itlsl crcu.o I hiktn ihts qeunsito is sujt aiknsg owh dsoe refev coruc in i/inaoimflcoanftninemt sat.otiinu +1
b1ackcoffee  ,So woh od yuo xinpale the utalca everf by usjt nicgahgn teh to?amse?rhtt Freev f'cee'tf IS derun eSmhcitaypt ontlr,co usjt teh nngiahcg the etraermtepu k(ile srehmttota) is ddmeatei yb ntokiceys nda hlhpysomtua.a +2
j000  ho i see twah uoy a,nem lewl i n'dtid nkwo ttha, so ntaskh for lanyfgirci .that eowrev,h dsabe no ruyo eapnoai,nxlt it dowlu tllsi tge su ot eht gtihr earwsn ihcwh si taloan"erti of shtaetctirom ste n,tio"p nto hte eefvr fcftee ef.tlis +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)

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 -1  upvote downvote
submitted by โˆ—mdmikek89(6)
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Oayk sbyo nad lgsri thsi qutisneo is irsaee than uoy tinhk.

Hoatmuplsyah arsyel via teh ihtyeptsmca nosveur sysemt to onroltc teh dybo hwne a enw est opnit sa bene hcreeda in setl s..s.fcea.yra.u.eve n.oy.tb.eni.fc.i

If het oecnicnnot ntebwee hte huophaatylsm dna linaps cdor n(yilma the spemiaythtc uto)wfol si tc,u eht sautlahm naontc yeral eht dboy otinecar fo a fvr,ee tbu teh lpuhyhotsmaa sfielt nca tills ghneac eth tse i.nopt

omBo

tnWiih hte bna,ir the otaiumonc vronseu ssemty si eelturgad by the ayl.homhputsa uAonoictm oitsnfcnu inducel noltroc of oi,sptearinr daccair tguealnrio (het racaicd lncorto tr)en,ec saovortom tiyvctai (eth vrooomsat enctr)e, nda itaernc xrleef nstcoai suhc as gui,ohcng ,znenegis lsnwiaolgw dan gnio.itmv

-EB cucro sa a uetsrl fo a chnega in tes tio.pn

A hpspane to ueacs hte -EB newh a ewn ets piont si hd.arcee

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI meyitscs efoint,nci dwol'ntu uyo etg anctsuoue sADNILOvoITa e.i.( iuidibsttver h?os)ck shiT wsa my nriseogan rof onchgios B) ni siht wakcy se.untqoi

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neilfespiritu  meSa +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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From nhdHarkoekoSuynoe no td:drei

Waht the siqntoue is nggteit ta is hte hciysttepam nicha asw pdes.ar It swa a elrtiber way of iongdrw ti.

urYo trroinea oymaahtuhlsp si bsoreelpnis rfo onilocg sefuraet adn is edrnu ierthypaatpsamc coltonr. A elosin uowld aseuc eiayhhrr.emtp

roYu iestororp hmsyouahtalp si lronbiseeps rfo ihetgan enhw 'rouey clod dan ot ergaeetn eth Fevre eoernpss dan is rdune paesiycmhtt noltrco. A oenlis dowul saecu moirythep.ah

In siht sneituqo ti is yipmls ginsak a snrpeo egts ksic, hpamaultoysh asw prsda,e twha n.speahp

enAwrs: mpltuaysahoh wlli tllis be aebl ot alevtee ets odby tmereuprtea to labtte ociintefn.

Hi:tn IF yeth eivg a soeuinqt lismari ot hsti btu drerodwe ot dilencu a lnsoei fo eth tasyeiptmhc rfiesb ro of the shpoh,mtalayu uyo uowdl ni urnt OTN eb bale to eeeanrgt a vreef sreeposn ot nonici.etf ehT hsaultpymhao wluod be yelnirte ruend aieacspymtptarh tonrloc

siTh adds eorm ctntxoe to teh acft eth Q esttas atht the sythaecmtpis saw ardspe

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oslerweberrendu  oS, hist sysa hsiepcytamt oals esradp nad umoaahhylstp asol rpedsa. enhT awht wsa gnrwo itwh isth liclanic s?eac? +1
adong  i nthik het yctihsptaem eymsst si claluyat meidairp /bc i'ts tuc eberfo ti nac ."oltftaouw".. astle is't the lony ayw tish mskea nesse +4
suckitnbme  I gae.er I hnkti eth qtnseiou tmse is nasiyg het hmyssceatpit eerw lseedi.no Nto ttah ythe weer .adrspe +4


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