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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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onrtlAetai of eth rtceoamtisth tes oiptn is a toacilhpamhy rpocsse teeiadmd yb agsrdnptsnloai dan is nnidenpteed of eht hsapiytctem vnrseou ssyemt.

B, ,C D, and E lal rieureq macsiyptteh eernsv ot llcitei a .seeornsp

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pg32  aCn eoynan planexi eht ncahimmes bndihe negivishr adn het tptymhaiesc vounsre sesyt?m +4
mdmikek89  lHuahtysmopa learsy rhugtoh the tmuaocnio vnsoure s.tsyme uoY uct eht aryl,e uyo cna nyol hnegac het oettcshimtar est ,iotnp but eth dboy n'tac etra.c +1
umpalumpa  usyG, I hnitk hatt fro the nsrhiveig rieanettlva the pitno si NOT atht ipyctaehstm evsrne noctorl ieihgnsrv ycl(aulat, I thnvea' fudon claisrte on dmpube atht says ttha eshivngri is drolcltone yb ).actemthiysp TeH steiaes awy to ithkn is taht isth tp has a iymcstse innticoef aak( emSiRcIsySs-t omatlraiymfn seseonrp ydesmo)n.r nI IS,SR pt acn evha t&T5;3l C or 3gt&8; ,C UBT ti si emro cnmoom to hvea erefv tahn i.heyompthra sinngoiCrde tsih, oyu acn eisyal utulore- het ngisrvhei neittr.lavae +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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phuytHmalosa onltclnirog ureerepmtta ste nipot si fbiyler innemdteo ni aohmtPa 1280 tindioe pega 31, haCeptr 2 III iCandral ssgin fo aoalifnmtimn D. erFve

Pyeoengs -g;&t hecapamrgo rleseea I1L- dan FNT ;&g-t sdecreani esycgnoxycaeol tacitviy ni psmaohutylah ucalrpreiasv clesl ;&-gt drsaeecin yhpushoaamtl PGE2 &-g;t reisda prerttmaeue ets potin

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 +0  upvote downvote
submitted by gribear(0)
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anC eoesomn ailxenp yhw wneh ouy tsnecrta eht iplasn rcdo ruirpeos ot eth elvle of ceiahmsptyt wfootul -- dna ouy gte a ssiecymt infinotce -- the eospesnr is taniotaler fo het thottsaiecmr ste tno?pi

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its_raining_jimbos  So I heocs tath eno eucbsea ste pinot si dloroecnlt by eht ymathohsplua P2GE( dan L1I- itaedme vreef ni the hhpsautmlo)ya dan the sert fo the wanser ecsochi vvedlnoi omgseniht eowlb het velle atht sha nbee dtsenac.etr otN %001 user fi tahtโ€™s uaecrcta uo.hthg +5
noselex  rgeeAd iwth _nsiiii_mg@arjsontb -- vFree si imetedda by lnagrtie ste nipot in hahtoyaus.lmp All teh eothr ecso,ich as arf as I can lelt, oevlniv eihsmaycptt esnrve dan hrtei eectfsf at gterta arsngo. +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 shit qsoiunet ownrg, tbu i iknth hawt sthi notqesiu is lraley giksan si what anhepsp in a cseimsyt ecntinof:i whchi si eevrf

ni yectissm i,oeicnnft eth stmo vbusooi nsgi ot kool rfo is a vee,fr tno ecyrssleain ,hersinivg tswgin,ea teah odcunoptir by wrobn t,af cet.

dna hwo osde evfre cuocr? liek oesenom raleady edonnme:ti eneyogsp ;t-&-g msaghepoarc renialegs 1LI adn TFN wichh eencarsis OXC acyttiiv in aluosthmhapy raiacpseulvr lel,cs ecresina odrtnoicup fo 2GPE in thhlaasmypuo and reest eht eutaemtprre tse tpnio.

i intkh teh hloew shrpae lc"epomte iasncrnotet of het pslian odrc opreusir ot teh ellev of y.pta..hsm"itce is a oirtsidacnt. ti ustj lltes uyo taht dlvpoeneetm of a eervf hsa tinhngo ot od wiht ti

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j000  ptnveoedlme of a feerv in iysetsmc tienciofn has ntinhgo ot do thiw amptetyhcis ronvues owl,f so vnee 'sit erunji,d ferve udolw illst uc.ocr I ntkih hsti enqstoui si tsuj kniasg how oesd eefrv occru in afltfoiamcniion/nenitm isnatuit.o +1
b1ackcoffee  oS, hwo od yuo xlnapie eht uctala erfve yb ujst gnnaihgc het otsh?ertt?ma rFeev tef'fce' IS uenrd yhaSticmetp otonrc,l tsuj eht cahinngg het aeturmrepte ie(kl m)atstorteh is mdaieted yb ctneykois adn alopsm.hhutya +2
j000  oh i ees awth yuo mean, wlel i dtdin' oknw tha,t so skahnt rof gialnriycf .htta rev,ehwo adsbe no ryuo tneoplaxain, it dwoul sillt tge su to teh thgir nwares hiwch is toatarlen"i of amhortcietst ets pnti,o" tno eht efrve tceeff tes.ifl +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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yakO obsy adn ilgrs hist iqnteuos si ariese naht you thkni.

mpstHalauohy rlyesa iav hte hticpamyste oseurvn stseym ot colnrto eht dyob newh a new tse nitop sa eneb ecdaerh in tsle f.crava..us...eysee noii.bcy..tn..ef

If het tocennncio bweetne eht phmayhsotlua nda ipsnla dcor lmain(y teh cemyatshtip wtflu)oo si ,tcu eht tluhmaas atnnoc rayel het bdoy conietra of a ,verfe utb eth soalhypmutha siletf anc lltis hecnag teh set optn.i

oBom

iihntW the ,brnai teh oatumnoci reovnsu syestm is eaertgdlu by eht phtym.uahloas ncooutiAm stcnnuoif einlucd ootcrnl fo iita,pronesr idracca gloeiatrnu t(eh aaidcrc conltro ec),ernt omrvtsaoo ictayvti he(t ovmoostra rec)nte, dan enctiar lferex scnitao hsuc as gcn,iuogh nzeig,nes gownsalwli nad otvgmi.ni

B-E rcuoc as a ultrse fo a aghnec in ste nip.ot

A ehapsnp ot uaesc the -EB nwhe a wne tse nitpo is ec.rdeah

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In miscesyt ,cnfteiino wldtun'o oyu get osancueut svIaNAIDTLOo ei..( ttudevribsii s)o?kch hisT aws ym aeonsnrig for gionohcs )B in tsih akwyc isoeut.qn

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neilfespiritu  Saem +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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omFr hneoroyeuonaSkdHk no :dretid

thaW hte qinteuso si tetging at is eth hypesmtctia nihca saw .rpaeds It swa a rbtereli wya fo owindgr t.i

Yruo oatnirer hulptsmhaayo si sprlonbeies rfo lncogoi aeftesru dna si ndure spaaptarcmtiyhe trlc.oon A ileosn uodlw ecaus p.yertrhiheam

Yuro itospeorr lhahmpyousta is oslbnireesp rfo tnieahg ewnh o'eyru cdlo nda to neeategr the eFvre nposesre and si uedrn msateicthyp cnltoro. A esionl olwdu eausc a.iyhhretpmo

In tihs iuqonets ti si symipl nskiag a ospenr sget ,cksi tlshuayoapmh wsa rp,esda hwta spape.hn

As:rnew aytluamhspoh lwil itlls eb albe to evaelet ets ydob truemeaeprt ot beatlt oit.nenfic

t:Hni FI tehy igev a iueqtons ismlira ot tihs utb wdoederr to enldcui a oliesn of eth etstyihcamp befris or of teh thuymaopl,ash you wdluo ni rtun TNO be ealb ot trneaeeg a fevre prseseon ot cfn.eintoi heT halspomyutah uodwl eb tlrienye rneud apaamisttyrecph oncltro

siTh dads emro xtetnco to hte atcf hte Q ssaett hatt teh sstypmciheta swa spdrae

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oslerweberrendu  ,oS tish sysa casitmtpyeh also drepsa adn hlhysoupatam aosl espdr.a hTne awht aws rwogn iwht hist llcaciin ca?s?e +1
adong  i ihntk eth cmyhtstapie metyss is aycaullt dipiarem bc/ ts'i tcu erefob ti can wof".t..uolt"a stlea t'is hte olny awy shti smeka ssene +4
suckitnbme  I ea.erg I iktnh eth intosqeu etms is yainsg het metiytascphs rwee l.ineosde tNo atth ehty rewe s.dpera +4


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