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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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oaAtteilnr of hte etamhositcrt est tpoin is a mlytohcipaah soscpre diadetme by solpnaasrnitgd dna si eitpdnnndee fo teh ihmaspecytt ruosevn tyssme.

,B C, D, dan E all eqrruie cyaehtpsitm evsner ot ilcietl a ronss.epe

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pg32  nCa anenoy linpxea teh cmshnieam inedbh sgriihnev dna eth mspiatecyth seurvon emsyst? +4
mdmikek89  Hhtulamaypso yrelsa hhotugr eht toacounim nvsueor .smyest uoY ctu eth layr,e ouy cna onyl haecng eth hesctaorttim ste ,opnit utb eht ydbo ntac' actr.e +1
umpalumpa  ,ysuG I ihktn hatt rfo eth srneihivg tiveartalne het poitn si NTO taht ymaecistpth eresvn tncolro ngsrievhi (tlcu,aaly I ev'hnta onfdu iecsrtal no eubdpm tath sasy ahtt ernivihsg si ooeltdlncr yb setptm.a)yihc THe aesstei ywa ot kitnh is ttah siht tp ahs a tmicysse cnifiento a(ka mSsiISytc-Rse mylrftnaoima orseensp o)dnr.semy In ISS,R pt anc ahev 3;5T< C ro 3;t&g8 C, UTB ti si orme moconm ot have reefv tnha ha.hmerotiyp iigrndneCso ,tihs oyu acn slyaei luetur-o eth irgisehvn et.livnatear +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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oHmtulpahays ntgrollicon tauepmteerr ets ionpt si eryblif minntdeeo ni atPomah 1028 otdeini geap 3,1 Cahrpte 2 III daCnlira gssin of amannitlfimo .D vFree

eegyoPsn t-;g& phrcaoegma ealrese -L1I nad NTF ;gt&- ideecnrsa lgoyyxeaconsce ttaiivcy ni ahsuaylpthmo crurlpeiavas cesll t&-g; sdcenaeir shmohaaplytu EPG2 -&;tg risade rueematerpt ste pinot

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 +0  upvote downvote
submitted by gribear(0)
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nCa osoenem elaxnpi hwy ewhn oyu trsatcne eht lpnais codr rrispeuo ot eht velel of ecsphtyimta lofwout -- and oyu get a ymectsis ioenicnft -- teh snsepero si otrtlneiaa of eht riemcsttthao set ntpi?o

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its_raining_jimbos  So I ehsoc hatt eno uaescbe ets itnop si ootrcdlenl by hte htmhuyospaal GE(P2 and 1L-I dteemai vfere in het ah)puylhsomta dna the tres of het aenwsr hicsoce eoindvvl gmtnesiho lwebo eth lleev atth sah bene c.rdtntseae otN 100% ures fi hโ€™tsat ecuartca o.hugth +5
noselex  Adeerg wthi isoibitjmra_n@_igns -- eevFr is dtiadmee yb anlertgi set optni in yhholsamtpau. lAl the erhot his,ocec as afr sa I cna lt,el oivlven tiehysacmpt ernsve dna hitre efcefts at taegtr .agrnos +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 iths uneqoist w,gnor utb i nihtk twah hits tiequsno si lraely gnakis si thaw hppnase in a tecmisys nnfceio:ti wcihh is eerfv

in csiteyms in,itcefon eth toms oubisvo gsni to okol fro is a ev,rfe nto leaesiycnrs sr,eignihv swiga,etn taeh copnduirto yb nobwr at,f .tce

adn ohw osde vreef ?ruocc ielk eoneosm lryaeda nmd:toniee egesnoyp -&;gt- pmhcasgoera asleingre L1I adn TNF hhiwc nscaeesir OCX ycivaitt ni hslyohaaptmu rsiplcaraeuv lc,lse ncersiea odrpuntioc fo GP2E ni hspatylmuhao dan srtee het aerurmpteet est ni.tpo

i tknih teh eohwl epahrs emptlcoe" nctesotnari of eht pnails dcro porieurs to eth lveel fo ys.e.athc.m"pit si a satdri.incot it tjus tllse ouy htat volneepetmd fo a ferve hsa hgotnni to od htiw ti

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j000  tnloeeepmvd fo a eerfv in yeisstcm icteofinn sha nhotnig to do itwh hipstcemayt novseur flow, so neve it's nidr,jeu eervf wloud lislt cu.roc I ihtnk hits otqiusne is jstu gnksia woh eosd erefv orcuc in nffntioicnemiaoinal/tm oiutnt.ais +1
b1ackcoffee  ,So how do you pelnaxi hte atcaul evfre by usjt ganihgnc hte ?atesht?mrot veeFr e'f'ctef SI rnedu tihypmeaStc c,ornotl tsuj the nhgaigcn teh emptreutaer ekl(i esoht)tmart si edaemitd yb kcyesinto and mslahot.pyauh +2
j000  oh i ese wath oyu ,mnae ewll i td'nid knwo a,tth so hnktsa rof fngiracyli t.aht h,orevwe bedas no ruyo aato,lnpeixn ti wludo litls egt us to het hgirt wrasne hiwhc si "artealitno of ioscrmtthtea tes ,p"toni nto hte refev ecfeft .esiflt +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 ysob dan srgil shti iesuqton is seaire than oyu itkhn.

uhtsyamopaHl reslya avi eth amyietstcph usvenro ymstse ot tcoonlr teh dybo whne a new tse noitp as bene derecah ni lset a..cevarese..s.uf.y i..n.e.otfcbiny.

If teh tonncoienc bntweee eht sohltaahypmu dan saipln ordc y(amlin het pyiatcmthse wl)tfuoo si ut,c eth mhlatsua tnonca lyaer eth yobd tanceroi of a efv,er but the opaumlhytahs elfsit cna lsitl cangeh teh tes i.tpon

moBo

nhWtii teh rnaib, eth miuaocotn veosunr tsemsy si tdgeealru by the h.oypsmalathu omAnciuot untcoisfn dnieucl lrtocno fo iaroprestin, acaidcr teglraniou the( raiccda lotncor )encte,r torovaoms tivciyta h(et vraoootsm e,e)rctn dna earitnc efxler citsano cuhs as cihno,gug ,igneesnz sglawlonwi and ivgmtni.o

EB- crcou as a surlet of a gnahec ni est .ontip

A apsnhpe to csuae teh E-B wehn a enw tse tonpi is decearh.

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In smcisyet iifco,netn uwtl'ndo ouy gte seonutuac TOALsIIaDvNo .i(.e sveuidrbitti s?)ochk sTih aws my sngainroe for ohosgicn )B ni hsti ywkac ie.tunqos

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neilfespiritu  Smea +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Form uokSenyornekhdHoa no t:dried

thWa the nuieqsto is egntgit at is hte ysicetampth nicha asw spdare. tI saw a lrebirte yaw of ngdowir ti.

urYo iarntroe aolpuymsathh si ibonsspreel fro lioongc ueatfers nda si dnrue tmphyicaesrtapa ltcoro.n A losnie ulowd casue per.thrmayehi

orYu opsritreo spaymatohhul is loneepissbr orf egthian whne 'yuore lcdo nda to areenget hte vFeer penserso nda is rednu yaeismtcpht nootc.lr A noslei ldouw casue hephtmariyo.

nI ihst itsoequn ti si yipmls ngiaks a opnrse egts k,ics hotpmlhasyau aws rs,adep what napse.hp

wrsn:eA muthaolsahpy wlli lstil be labe to eevaetl tse odyb eepermrtaut to bteatl fc.nitonie

H:tin FI htye vegi a netisqou ilmrsia ot hsti utb doweerrd ot neduicl a ineslo fo het tyhscptmiae isrbfe or of teh yatlmahphuso, ouy uowdl ni rntu NTO eb bela to eagrtnee a freve psreonse ot .ioftcinne eTh uoytshaplahm oldwu eb yntrelei drune misteayhtapaprc tlcrono

siTh asdd eorm tectoxn ot het acft eht Q tsaset thta het cthatyseispm saw reapds

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oslerweberrendu  So, tihs yssa ctsthapyime loas rdapes dna tlpsauhhmoay osal adps.re neTh ahwt swa orgnw itwh thsi iilanlcc e?asc? +1
adong  i hktni eth imhytptsace smtyes si aaycullt idipmera b/c its' cut febero ti cna w.of"l"..ttauo selat si't hte nloy awy tshi mskea sesen +4
suckitnbme  I e.earg I hiktn hte nitqoues mste si naisyg eth pshetmcyitsa reew ndle.oeis tNo atht ehty reew dspae.r +4


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