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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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Aelrntotai fo the ethrosmcttia tse ption is a aohlahpmytic crspsoe tedmedia yb agnoridptnlssa nda is nneptdednei of het aypthsiemtc sernuvo syesmt.

,B C, ,D nad E all erruieq pcyimstteah sevenr ot eilctli a soenrs.pe

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pg32  naC yanoen eaxnlip hte mnaimechs hibedn vgrhsinei nad eht tmiethspyca eouvrns emt?sys +4
mdmikek89  mhypHuaslota eyalrs uthorhg eth tuinomoac osuenvr t.meyss Yuo uct het ,eylar oyu cna yoln nacgeh teh hitmcottresa set opi,nt but hte bdyo antc' cerat. +1
umpalumpa  ,Gusy I intkh atth ofr eht nseivihgr venartaltei eth nopti si ONT that ectimashypt evsenr otrnlco ierighsvn cla,yualt( I htev'an oufnd sicatler on meubpd hatt ysas htat nriegsihv si onlldtcroe by mtecpisa.yth) eHT teiseas way ot khitn is that htsi pt hsa a smeiscyt ioefnintc k(aa -mtSyiIsScsRe rnlfamaomtyi rpesenso s)md.noeyr nI SSRI, tp acn hvae t3;5Tl& C or g&3t;8 ,C UBT ti is rmeo oommcn ot have vfeer tanh aoiehyt.pmrh seingCrndoi ,sthi yuo nac aesily oerul-ut hte ievsnihrg eatert.ivlna +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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molpyhtHausa lnoilrtoncg pateruetrme est tiopn is lyfbier dtnoeienm ni Potamah 0812 ntioedi paeg 31, apheCrt 2 III nlaCdair sgsni of iimmlntoafan .D eevrF

nPegosey ;-&tg rhgoapemac elsaree L1I- adn NTF t;g-& anceeisdr olncesaogexyyc icttyaiv ni atahsyuhlpom aeruacisrvpl lcsle t;&g- esnraceid ysothuaamhpl EPG2 -t&g; dairse pumearteert set tipon

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 +0  upvote downvote
submitted by gribear(0)
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Can osnomee leaixnp yhw nehw ouy nsrttace teh sanpli cord sreoipur ot het evlel of ceiaphsmytt otwoulf -- adn yuo get a cyisestm icotenfin -- eth senerops si aarilnoett fo het tosrmtitaech tes ?ptoin

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its_raining_jimbos  oS I oesch that eno uacsebe tse piotn is olntdoerlc yb the yalopshhutma P(GE2 dan 1IL- iemdtae rfeev ni eth )yphuloasatmh nad hte trse fo eth wraens cehcsoi oievndlv ethgsnomi oebwl eth leevl hatt ahs been ase.dtetrcn toN %100 resu fi shatโ€™t atcucrea ght.uoh +5
noselex  gAedre tiwh sjrni_i@itgosani_bm -- vreFe is tadeedmi by grtaieln ets pniot in hpmauytoals.h lAl hte herto ce,oichs as raf sa I can te,ll vinvole thimapsecyt veresn nad ihtre cetefsf at atergt aso.nrg +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 ogt hsit sqotuien wn,org tub i tnhik hwta siht qeouinst is yrlela ksngai si awth hanpesp in a sstimyce nci:neftoi whhci si rvefe

in semtsyci i,eifnoctn teh omts uiobovs isgn to olko rof si a v,erfe tno slaysrnecei iihgersv,n ews,angit ehat tducopnroi yb rwobn taf, c.te

adn how oeds eferv ucc?or leik oenmose dreyaal eme:otinnd ynpeoges ;g-&-t erohpaacsmg glniersea I1L nda FNT hwcih rsscnaeei XCO tctviaiy ni uashhtoamply piacerluvsra cll,se srinecae dtcnproiou of GPE2 in hoyhutpmslaa nda etesr hte meaturerpet tse o.iptn

i htkni hte lwheo ehasrp pmtc"eeol notcitnsear fo eth palsin crod speriuro ot teh leevl of .ttehs.api.mc"y is a stdrctoinai. it ustj eltls you atth vdepoeemlnt fo a rfeve ash ighnotn to do iwht ti

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j000  eoleptdvmen of a vfere in yctssemi eicfonnti sha oghnint to do twhi amptitcheys ovurnes ol,wf os enev is't rdjune,i ferev dluow tslil u.orcc I nktih iths sonueqti is jsut gsinka woh dose refve occur ni minnoatieilaffmctnn/oi iisouantt. +1
b1ackcoffee  So, how od yuo anlpeix eth lcaaut eevrf yb tusj gnhngaci teh o?t?temsthra reveF efct'fe' SI rduen tiapehSytmc lctro,no ustj teh aihgcnng het epatmtruere ielk( tteoshm)art si dmeeitad by cskinyoet dan omaphhtu.ysal +2
j000  ho i see whta uyo ,anem lwle i itddn' kown ,that so akhstn rof rnaclygifi htt.a vhrow,ee ebads no yruo letonana,ipx it wlduo istll get us ot the hgtir nreaws hciwh si ritata"eoln fo tschetomrita tes "n,topi otn the vrefe etcfef stilfe. +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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yaOk bsoy dna glsir isth esitqnuo is esiear hant uoy ik.thn

lthuasomyapH lyares vai teh staetpyimhc eovunsr ytsmes to ctlnoro eth body hnew a nwe set tniop as neeb eecardh ni stle .cfs.raue.avs..eye. ei.ifyn.b.c..tno

fI the ceonnoicnt ewbeetn teh yhtmaoaphusl dna sailpn dcro ymal(in hte ehmpcatstyi l)uooftw si cut, eth tlahaums cntona aeylr eht dybo cinteaor fo a efer,v tub hte mpyaahhlutos lfeist nca istll agnche eth ste .ponit

Boom

Whniit the anbi,r teh imontuoca noersuv mtssye si ueealgrdt yb teh tusm.hypolhaa ctouionmA cnoinstfu cluedni orcnlot fo nrosiie,ptra driacca gtulrinaeo h(te aacdcri ncolotr re,n)ect ovaroostm tivactiy h(te ovaroomts e)rec,tn nda rciatne lxrefe casitno uhcs sa uonhig,cg nee,ingsz goawwllins nad i.tomgvin

BE- cuocr as a lrutse of a cnhega ni tse .onpti

A spnhpea ot sacue the -EB wnhe a enw ste opnit is h.ceader

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In issctyem on,tneiifc undwot'l yuo etg aostuecnu IaTLvADONsoI (.ie. iiistuetrdvb hk)o?cs iThs asw ym ongianers rfo iscnogoh B) in stih wkayc u.seitqon

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neilfespiritu  Same +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Fomr uHkneSkooerhdyano on :deitdr

ahWt eth eintsqou is tginetg ta si the epsmahiyttc ihacn asw .easdrp tI swa a elitrreb wya fo donigrw i.t

Yoru neariort yshauhmapolt is pnslireeobs fro iocngol ufaetsre and is rednu hrcptpyaseaitam con.rtlo A inlsoe ouwdl sucea rta.irphyeehm

orYu eoorprist yhtuahaoplsm is isproeelsnb rof ihentag ewnh r'yueo ocld and ot rengtaee eht Freev oesrensp nad si denur iyapehcsmtt cortl.no A enliso lwodu aseuc timheahyp.ro

nI isht unstoeqi ti is mpilys insgak a snpero tegs ks,ic htypmoalusha aws ea,psdr thaw pnphse.a

sen:wAr laumsaypthoh llwi listl eb ebal ot ateelev est yobd mrarupteete to tlteba o.nfcnetii

n:itH IF ythe eigv a etousiqn rlmaiis ot hist tub edroedwr to dcnleui a ensiol fo hte ycheispttam isbref ro fo hte hasu,paytomlh you uoldw in turn TON be aebl ot raneteeg a efrve snerpeos ot nceotini.f ehT lhhumpastayo luwod eb nelrteyi dnure crtphpaaamytsie ooclrtn

iThs adds reom etcxtno to hte tfac eth Q ssatte atht teh yapemtcssith swa epdars

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oslerweberrendu  ,oS ihts ssya phtscmiaeyt slao dasrpe nad uahptslayomh losa adre.ps hnTe hwta asw orwng whit sith nilcclia a?esc? +1
adong  i itknh the iypcmaethts tsyems si llaacytu aipidrme /bc t'si ctu oeerfb ti nac ..o.at"tfl"uow eslat ti's teh nlyo ywa sthi meask esnse +4
suckitnbme  I ereg.a I tkhni teh tuineosq mset si iangys het paiceymshstt erwe eoseln.di Nto thta tyeh reew e.asdpr +4


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