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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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oaitrnletA fo eth stmtcieohtra ste tnoip si a clamhyptoaih psersco ddiaeemt yb gsltapnraiodsn dan si inendeedntp fo the mtshyaiecpt rusnove yssmet.

,B ,C D, dan E lal rireque iethampscty nserve ot ilicelt a sepsneo.r

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pg32  Can nnoeya pxilaen hte mehscanmi denhib iivhregsn dna the mhstaeytpci nrsovue st?seym +4
mdmikek89  pasyuhHmltoa ealyrs hgourht eth ocumnaito rveousn s.ystme ouY uct teh ylare, you can olyn ncgaeh hte thitoamtrces tse ,nipot ubt teh boyd tcan' cte.ra +1
umpalumpa  Gysu, I ihknt hatt fro teh iehnsrvgi trlievaatne the ption is TNO htta yettchpaims vneesr orcntlo siivhrnge (ycta,aull I tna'vhe dufno raleisct no mdpbue thta asys tath hirsinevg is lrtdooncle by .tcm)eshapity TeH etassei ayw ot inhkt si thta ihst tp ahs a scsyteim tiofeicnn aa(k R-SeSsticsymI tlnoyafmamri rsnosepe m.ydnr)soe nI IRSS, pt cna ehav &5t3;lT C ro t3;g8& C, BTU it si orme ommnoc ot vaeh everf atnh permahihtyo. rCigdnosnie ,ihts uyo nca ayesil rlout-ue eth ingirehvs irvel.ataent +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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phamaolHsyut onlrngoitcl aemetpterru ste intop is lieyfbr deetnmion ni othaaPm 8120 oeiintd agep ,13 tarehpC 2 III aladCrni sigsn of iinnmoatmfal .D eerFv

egPneoys -g&t; roahpacgem eeasrel LI-1 dan FNT &tg;- isnaedecr yoelngsycoxace iatytvic ni syaphhomltua pluirsveraca clesl &-g;t caeneisrd sohymualahtp P2EG ;>- srdaie prtruaemeet ste onpit

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 +0  upvote downvote
submitted by gribear(0)
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Cna esonmoe ixalnep why nhwe oyu tsercant hte pliasn cdro ipurreso ot het eelvl of mtyaiphstce loowfut -- nad ouy get a myessict finiotecn -- eth psesreno is eaiatrotln fo eht hrttsmaoceit tse t?oinp

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its_raining_jimbos  oS I cesoh htta neo cauebes ste niotp si ooltnecdlr yb teh ytlsmaohhupa G2PE( dna LI-1 tdeiame rfeev ni eth luaphohmysta) adn eth etsr of hte wnesra cheisoc ivdlonve mntghiseo obewl eth lelev that ahs nbee naeesrct.td oNt 0%10 uesr fi tsatโ€™h atcareuc huo.ght +5
noselex  egdAer htwi sriismtj_g@_iaibnno -- Fvere si itemddae yb taeginrl tes ionpt in olamstu.yahph lAl het ohetr i,heoccs as far sa I nac ltel, eoinvvl apmehttsyci nesrev and rhtei ceetffs ta ragett gar.nso +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 tgo hsit tequsion ow,ngr utb i htnki thwa thsi esqtnoiu is alrley gsaink is awht sanppeh ni a eyicsmts i:tionencf wihch si efvre

ni ymssetci cento,iifn hte msot sbuoovi sign to kloo ofr si a ,efrev otn icynlasrsee ivig,herns gswtaien, aeth oounpdirct by bwrno ,taf .etc

dna woh soed vfere cour?c keli onosmee adlraye dntnmeoie: geeosnpy &t;--g hmarpcosgea enlrigsea IL1 dan FTN hciwh ieecsanrs OCX vtyiiatc ni yahoapmthlsu uprlseavirac lslec, reeiasnc odcotrnpui of EPG2 ni myluaphthaso adn reset eht reeateurpmt tes onp.it

i ikhnt eth lehwo srhape "elepctom nonceiatstr of the silanp codr rpeuiosr ot the lelev of .cim"hs.ty.teap si a tctaodii.nsr ti utsj ltles you that lednvopmtee of a fever ahs goitnhn to od ithw ti

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j000  etnepedlmvo fo a vefer in tceysism otnniefci sha ghnotni ot do ihtw myhaeipctst nvreuos lwo,f os evne st'i irjnud,e fever lowdu isllt rco.uc I htikn stih uenotisq is sjtu kniasg owh edso vrfee ucocr in ociioli/fmmnnatfitanen otnai.stiu +1
b1ackcoffee  So, who do uyo lnxiape het cutaal vrfee by jsut cnhiggan hte t?ero?stmhat veFer fte'ef'c IS dreun yeahStmictp lnctro,o ujst eht ianggnch hte temeutrrape e(lki rmsotthat)e is ieaddmet yb eskiocnty nda oaha.ptlmshuy +2
j000  ho i ese atwh uyo e,anm lwle i ddn'ti oknw ,tath os skhnat rof iafirgcynl .ahtt owrev,he ebsda no royu ateoal,npxin it oudwl sillt teg su ot eth gtrhi weanrs hiwch si rattei"nloa of atthtcrimose tse ton"pi, not teh ervef tfeecf fis.tle +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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Oaky ysbo adn igslr htis tequnios is eiaers tahn yuo it.nkh

yhpamustaHol yasrel aiv teh eapthysmcti snorveu emstys ot onortlc teh ydob ehwn a wen set ipotn as bnee eaecdhr in tels .y.eacusef..revas.. .f.ti..boienncy.

If the ntonccioen eebwent the hhpsoamltuay and lnaspi ocdr anl(ymi teh eatiytphcsm t)uflwoo is ut,c the smlthuaa actnno alrey eht dybo enatoicr of a ef,erv btu hte poyhhlmuatas lsteif nac lltsi aechgn the set .tnopi

Boom

inWhti eth nirba, teh ticamnouo vsrueno mysets is taguelder by the ao.ptymluhsah numctiAoo uscinnfto duienlc tolrcno of itops,arinre rciacda ugarlnetoi t(eh rdacaci ortclon tcee,r)n rvoatmoso ctyvtaii th(e vtmarosoo ,te)rnec dna cetnira exlerf atincso ushc sa uihgcgn,o zegnsen,i algownislw adn itngmivo.

BE- cucro sa a etlrsu fo a nghaec ni tes nto.ip

A pnepash to acseu eth BE- wehn a wen tes ontip is cedrea.h

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI emcystsi oefntci,in 'oltdwnu uyo tge atncueuso LDaAvIOIosNT .e(.i vsidbuteirit okhs)c? hsiT was ym nroneisga ofr hicgosno )B in thsi kacyw .noieuqst

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neilfespiritu  maSe +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Fomr ookdoknShuyrHneea no dr:tide

aWht hte iqutoesn is ggtetni at is het miahteytscp naich wsa apdesr. It was a tiebrelr ayw fo rionwgd it.

ruYo atineorr tahshoapuylm si rbnolesspie for cionogl eursfeat nad si rnude eamchtprsityapa crnto.lo A oselni uwldo ceasu pmarieehhry.t

uYor siroertop yaslomhthapu is opieslrnesb for htigane wenh r'euoy lcod dna to aengetre het rFvee orenseps nad is nerud hteimpstcya oltcn.ro A eslnio wodul scaue taohrh.miype

In tshi tuseoniq it is ypmils agisnk a nsepor tesg ,iksc tlhhpaaymous saw e,pdras twha .phnapes

wrs:nAe mathohalupys ilwl lstli be aebl ot aeelevt ste oybd raerteptume ot ettalb nnit.cfieo

n:Hti FI eyht ievg a qistnoeu lmsairi to ihst tub rowederd ot duilnce a oelnsi fo het tsyamepcthi rfebis or of hte ltuaapyhsho,m yuo luwdo ni rutn TON eb ebal ot ngeereat a reevf ernospse ot inef.cnoit ehT ayuhhtsopaml wduol be lenyeitr ndure eatamcytishaprp ncoltro

isTh sdda emro xcettno ot het fatc eth Q saetts hatt hte cspyshtamiet swa dserpa

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oslerweberrendu  ,So htis says pecttmihasy loas dpeasr dan aapysthomulh also rpads.e Tehn wtha asw rogwn htiw isth aillicnc e?s?ca +1
adong  i hknit het ipttashmcey eytsms is laclaytu padeirmi cb/ 'tis cut ferobe it cna u.."fowto"lat. altes sti' the noyl ayw htsi seamk essne +4
suckitnbme  I e.agre I kinth eht nuietsoq tsme si yignsa teh cemhptstyisa weer eis.eldon Not taht hyet reew e.aprds +4


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