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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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arttlioAen fo eht shirtctmotea ets toipn is a imthohayacpl ossperc aemdedti by gldosptanniras dan si ntnpddeeine of the tsciamtephy rsnvuoe syetms.

B, C, ,D nda E lla ieqruer ytmtphceias enrves to iilctel a rpese.ons

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pg32  anC ynnaeo iplanxe eth cmnamihes ebndhi snrihegiv adn hte shpeacittmy renuosv yses?tm +4
mdmikek89  pouaHtslmyha esyarl uhtgroh het auomtinco rnovesu tms.esy oYu tuc het ,ayrel yuo can lyon canghe het httioesctrma ste opi,nt tub eht bdyo an'ct ce.tar +1
umpalumpa  ,sGuy I tnkih thta orf the vsiirgehn teariltaven hte nopit si TON tath styeitcpahm envsre tocnrol rnhevsigi ul,c(alyta I hatne'v fnuod eialscrt on pebudm that says that nihrgsevi si nootrldlec by actti)sheym.p THe etesias wya ot tikhn si ttah shti pt has a tmcissye ecninitfo ak(a ts-SsSimycRIe lyifamtroanm esepnsor es)dy.morn In RSIS, tp cna heva t;3l&T5 C ro g3;t&8 C, TBU it si meor ommocn ot veah refve nhta prtmyo.ahhei eorgiindsCn t,hsi yuo cna eyisal t-ueluor the nsvigehri iavtnretal.e +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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aHmythlaospu glolnntorci etaprtrmuee set tnipo is lfbeyri eeodimntn in Pthaamo 1082 neidoit pgea 13, Caertph 2 III ndalaiCr gsnsi of aimtoflminna .D Fveer

oesyPgne t-&;g mpagarhoce aersele -I1L dna TNF ;g-&t anredeisc oalxeyoycegcsn vtiaycit ni yaolumtshaph vlrucaesripa clsel t-&;g crnsdeeia ylthsahpoaum E2GP ;&t-g seadir aterumptree tes ptoin

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 +0  upvote downvote
submitted by gribear(0)
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Cna noosmee nxapile yhw hnew you ansectrt het pnilas rdoc iepruors to the lelev of ctepytmiash flwotou -- nad uyo tge a sitcsmey innfcioet -- eth seenpsro si tlrneaoiat fo eht ttimtraschoe ste np?ito

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its_raining_jimbos  So I hocse taht one absceeu ets otpni si elotlcdonr yb the ohsaylhutmpa PG(E2 nda 1IL- meidate reefv ni het sohumpyatlah) dan hte sert of the nerswa escchoi neodvilv hmontgsei lweob eth eelvl ttha sah bnee sedacnettr. tNo 1%00 ersu if hโ€™ttas etaucrca to.hugh +5
noselex  gdAree hwit itssin_nmgiajoi@_br -- rFeve si imetaded by elrgiatn est otnpi ni hapsohlaymut. All hte toher csce,ioh sa rfa as I can lel,t involve myaptcthise sevner nad erthi fetsefc at ettrga rnos.ga +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 otg siht oneqitsu nworg, tbu i hnikt thwa sthi ntuioqes is eayllr aginks is twha pphasen in a tsmcesyi ecitonn:if cwhhi si efver

ni tysciems fni,noteci eht stmo sbuvoio ings ot lkoo orf is a f,rvee nto yiscanelrse ,higiesnrv git,aewsn haet itroncudpo by brwno fat, etc.

nda who dose vrefe c?uroc elki smoeeon lryaead oemnni:etd oygsneep ;-&g-t rmpsacahego salnieerg I1L nad NTF chihw sneicrsae XOC avtcyiti in yaolmauphhst acsapverriul ls,cel ecaesrin cotrnidopu fo 2GEP ni oyuphalshtam and eters the etetrampeur ste pi.not

i hinkt the hwelo eahspr eemop"ltc ionrnsctaet of teh ailpns rdoc roupesir ot the elvel fo t.stcihea.y.p"m is a oisit.ncdrat it stuj eltls uyo that ntevledopem of a fevre ahs hnognti to do htiw it

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j000  eneopmldvet of a feerv ni yiscesmt onctniife ahs ihntngo ot od wthi ytstehpaimc ovnreus ,flwo so neev tsi' u,iedrnj rfeev ldowu ltlsi rucc.o I itnkh thsi nuoqiets is tusj ganski owh odse evefr cucro in nno/maiitclifnoitnmfae st.utioina +1
b1ackcoffee  oS, ohw od yuo eapnilx eht clauta vfere yb juts nnaggcih teh t?shterot?am vFere ecf'tf'e IS dunre eSamhpictyt cnol,otr tujs eht nciagngh hte murtarepete ekl(i thetas)ortm si dmeeitda by kytsinoce nda sahaulmhty.po +2
j000  ho i see tawh uoy ,enam ewll i 'ddnti onwk a,htt so stkhan orf iaifrlngcy t.hat ervew,oh adebs on ruoy xa,enntlpiao ti oduwl llsti gte us to teh ithgr rwnsea wihhc is l"nortiatea fo aoemihcttstr ste ipo,n"t tno het vefre fctefe lt.iefs +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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Oyka boys and sirlg sthi qiouesnt si eeisar anth you .tnikh

pamtuhalHsyo elsyar iva the mctasieypth rseuvno mtysse ot nlcroot eth oydb wehn a wne tes tpnio as nebe aedrceh ni stel rse.e.uy.asf..evca. e...iyc..oinbtfn

fI eth nnnocotiec eeebwtn the luayohsapthm dan nlaips dorc inmyl(a eth mhtcpyatsie otuofwl) si tuc, the mstaalhu natcon alyer eth ydob irnocate fo a v,reef utb eth lhotasaphmyu istlef can litls achgen het set oitpn.

ooBm

hWtini het n,arib hte nootmcuia uovrsen tssyme si lrudetega by the h.saalmhyoput ucitmooAn sionfuntc diuecnl lntoocr fo rtnaispor,ie accdrai untgiaolre (eht aacrcid roctoln ,ertnec) oomoasrvt iatyvtic t(eh msovaotor ct)nr,ee dna ierntac erxfle iosantc hcsu sa in,hogcgu in,egensz ilgwosanwl adn gio.vnitm

B-E cucor as a tesrul of a hgneca ni ets ot.ipn

A pnhsepa ot escua het -EB hwne a nwe set opnit is rhedc.ea

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI stemisyc ,nineoitfc tow'duln oyu teg seatnoucu sNLIDoAavITO ..ie( tiiudiebtsrv o?k)hsc hTis swa my ageonrnis rof gochnios B) ni tshi akywc it.soeuqn

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neilfespiritu  Sema +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Fomr HerkoySaoekdnnuoh no ed:rtdi

ahtW eht uqtsieon si getntig ta si eth mspehictyat achni saw despa.r It wsa a rreibelt ywa fo rdwgino .ti

Yrou oinrtear malphoauhtys si losnibesper for nloigoc rstfeeau and is druen shaeaypptritcma lrnc.oto A nsloei uowdl uecsa ihetrramehy.p

Your eorropsit hyaahtspouml si iprbenolsse orf tegahin wneh oye'ru dloc dna to agereetn het Fveer rosnepse dna is endru semtahciypt .tclorno A inloes ouwdl sueca pmyoehhat.ir

nI isht nqsetoiu ti is smylip nigaks a nersop tsge sik,c hytalmaopsuh saw dsepar, hwta nah.epsp

reAwsn: mtlhuyspahao iwll llits eb aleb ot eealtve tse odby teepumrrate ot abeltt teion.fnic

Hit:n FI ehyt gvei a sitqeuno lrasiim to tish ubt ederwdro ot nidlecu a senlio of hte mtyeiachpst bsreif or fo the om,ulaphyhtsa you duwol in trun TON eb beal to eteganre a fvree orsneeps to i.ioecntnf heT tpymasauholh oudlw eb lnyrtiee dernu imspyahatparetc rnotclo

Thsi adsd ermo econxtt ot eht tfac het Q eastst atht hte mcyietssapht asw apders

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oslerweberrendu  o,S itsh ayss htymictasep olsa sdaepr nad soupalaymhth aosl apdre.s eTnh hwat swa gnwro tihw hsti lacnicil c?es?a +1
adong  i ihtnk the tmayhicetps tymsse si uyatclla miiedapr b/c st'i uct eorfeb it can tftl.a.u"."owo tsael sti' teh ynlo way siht saemk eesns +4
suckitnbme  I a.gree I tkinh eht usitenqo setm is nsiagy eht paytestscimh rwee .sdneolei Not that thye rewe despar. +4


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