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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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reltoiAnat fo het ricomahtestt est tnpio is a ahmtaopiyclh scrpose detmidae yb nlaprstondsgia adn is peniendnedt fo eth yhetptiacsm ervonus smetsy.

,B ,C ,D nad E lal ruqiere sattyecihpm eesvrn ot celitil a .seorespn

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pg32  aCn annoey peaxnli eth immehancs hdbien gesihvrni adn the mttispahyec srevuno syem?ts +4
mdmikek89  tmsyHuaolpha yaresl ouhghtr eth tnoacimou eurvnos tems.sy ouY utc het arl,ey ouy cna lnoy aehgcn hte ishamcrtteot est ipnt,o tub het ydob a'cnt rte.ca +1
umpalumpa  Gsu,y I nhtki ttah rfo eth rsivinheg enelatitavr eth tinop is TON thta eptatychism vseern tnolcro isrvenhgi l(,ycutala I veanht' noduf tarceisl on depmbu taht syas ttah einhvrsgi is lecnrootdl yb emtah.sycpt)i HeT iteessa yaw ot tihkn is htat ihts tp ash a tmscysei cnnioefti ka(a ScSis-RmysIte lrniyaomamtf eeossprn rs)d.meoyn nI ,RSSI tp cna vhae ;5tTl3& C or 3;gt8& C, BTU it si meor ncommo ot vhea veref atnh aptoeirhm.hy dsnCioeirgn sh,ti ouy cna ylsiae rl-uoeut eht sinvhegir te.vtnraieal +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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mpHolathyusa cnoinolrtlg tepumeraret est onitp si reiyflb inndmtoee ni aomtaPh 0128 nodtiie pgae ,13 heaptrC 2 III adnrlCia gnssi fo nmfmonliiaat D. eeFrv

oseyngPe &;tg- hrgcmpaaoe lseeear -L1I adn FNT ;t&-g edacnreis elsoyxcegcnoay ticiyavt ni pmhatysulaoh eurarpcasvil clsle ;-gt& acenidrse oaumlytaphhs PEG2 g;t-& dsaier rerpaettmue tse piton

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 +0  upvote downvote
submitted by gribear(0)
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anC mooense pineaxl why whne yuo saenttrc hte ispanl dcro piroerus to the velle fo ieymttacsph owftuol -- dan yuo gte a ytesiscm tofniecni -- teh penossre is riltaontae fo eth hrsmeiaottct set iotp?n

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its_raining_jimbos  So I ecsho ttah oen abueesc ste otnip is tooercllnd yb het slytaaohuhmp 2(EGP and LI1- idaemet rvefe in eht yoplamhua)hts adn het erst fo teh renwas hceosci vdveolni ngiemtsho welob hte elevl tath ahs bnee rdtctese.an tNo 0%01 uesr fi tstโ€™ah carteuac .uothhg +5
noselex  dAeegr wtih mitgiisoanibn_jr@s_ -- reveF si tdeidame by nragltei est onpit ni uysmholhtpaa. lAl teh rehot iehcsc,o as rfa sa I nac tlle, vonleiv hcspemitaty ersenv dan rehti tefsfce ta rtaget gsaro.n +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 sith qtienous ro,wng utb i tkhni whta tihs inoqsuet is ylalre nsgika is wath epshanp in a mstcesyi feonci:int ihcwh si veerf

in scmitsey ,iicnnfeto the msot uoisovb gsin to loko orf is a revfe, not ycerslinsea evisrg,nih a,isntegw ahet opiuocdtrn yb rbwno tfa, etc.

nad hwo eods erfve ?ouccr eikl oenesom eaadlry :imneedton peoygsne -;tg-& hocapasregm eglisaenr IL1 nad TFN ihwhc asnerecis OXC vitcaiyt in haytmshupola caivsaulrepr clle,s inesraec diuonrctop of PEG2 in aputlshaymoh nad eters the areutepmret est opint.

i nkhit eth wlheo ashper cotepl"em osirtentnca of eht psilna codr uiporres ot eth elvel of tmcypast".h.ei. is a raticdno.sti it jtus tlels you tath dnoeetplvme of a vfeer sah itgnohn to do wiht it

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j000  veelpmoetnd of a fveer ni mcestisy nnieocitf has innogth ot do thwi ythcmsiptae rveunso lw,of so nvee si't ,drjnuie freve would itlsl occru. I tkhni siht inotuseq si stju kgnsai how edos vrfee crouc ni mifoiaoclant/mnfieinnt ia.ttnouis +1
b1ackcoffee  oS, how do uyo npeailx het tuaacl fevre yb jstu chiaggnn het ht?t?tarmseo ereFv te'e'fcf IS udren tcypStamhei otoclr,n jsut teh nnhgciga teh utprtreeame (eilk tt)htsmeoar is maeetddi yb iyonetcsk nad hamopyt.hluas +2
j000  oh i ese hwta ouy ,eman ellw i ndt'di nowk htat, so sakhtn for firnlyciag .atth wo,vehre abeds on ouyr pon,antaliex ti uwodl ilstl gte su to eht igthr naserw hhwci is lnrtiteaa"o of itrcmsehtaot ste ino,tp" otn eht fever efftce s.leift +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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Okay yobs nda slrig itsh sutiqneo is seeira atnh oyu n.itkh

aosathmupyHl rslyae aiv het mtstiyepahc oesunvr sesmty to cnortlo hte obdy hwen a enw ets noitp sa nbee crdahee in lste res..v..yeusc.fa.ae ..ytiobfen.in..c

fI teh tccnneooni ewtnebe eht suoathyamlph and aplnsi odcr y(inmla teh stpacihetmy fow)outl si ,tcu hte sumalaht aonntc yreal the byod iecranot fo a erf,ev tbu teh ophhmltsauya tfseli acn sltil nceahg teh est ntopi.

Bmoo

iWihtn eht rin,ba the iuotancmo unerovs sysetm is duegtrale yb teh olua.amthpshy mAunoocit tosfncuin inceldu ntroclo fo tiirser,opna diraacc gtuonralie hte( cacardi oconltr cne,tr)e tormovaos ityivatc eht( mavrootso n),rtcee nad ectrnia erxelf coatnis chus as iggh,ucno e,igznsen wngwsollia dan .vigitmno

EB- rccou sa a ltresu fo a hnecga ni tse ntop.i

A ephsanp to uacse the B-E whne a ewn ste niotp is eh.cadre

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI emictyss inieftonc, dwn'otul you egt ntuusaoec oINLIavAOTDs .e.i( svideiutbitr cok?)hs hisT asw my snaoirgne fro coogsnih B) in ihts kwayc noq.etuis

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neilfespiritu  emaS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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romF nnSehkoHkoeoaurdy no de:idtr

Wtha hte enqousit si egitngt at is eht eitspyhmcat ciahn swa .apsred It swa a eerltrbi ayw fo ndroigw .it

ouYr nrateior slapohmhauyt is olerbpsnise ofr iglocon fseaeurt dna si rdeun pptamahtrseaicy onor.tlc A nseloi dlowu sueac .mhrahypeteri

Yuro etpsroiro staumpaylhoh is pnbieslseor for iehatgn wnhe yue'ro ocld nda to rateneeg teh eFver poneerss dan is urnde ptityehcmsa n.troocl A eisnlo dlwou aecsu homhyrp.eita

nI ihst qiutenso ti is sypmil nksgia a pnreos setg cik,s uhatsoymhpal saw ared,sp wath nhpaep.s

ens:Awr yaupsthmlaho llwi lslit be laeb ot vleaeet tse yodb emuprrettae ot ltetab ifeoi.cntn

t:niH IF tehy vieg a isneuoqt slairmi to this tub dreowerd ot lniedcu a nslioe fo the phsttcmyeai reisfb ro of teh htohmlpua,ays uyo lwoud ni trun NOT be elab to entreaeg a refev nrpsseoe ot oennit.fci ehT ahmatlopuhys udlwo eb yliernet ruedn caareasyhtpmtip otcnlro

sihT asdd omre ctnetox ot teh ftac the Q tstase atth hte tshaicmpesyt saw adrsep

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oslerweberrendu  So, hist says pimcyheatst olsa dapesr and thmosyupalah loas apsed.r ehTn wtha asw ogwrn wthi hsit incallci cea?s? +1
adong  i ikhtn eht itcsyhemapt etmssy is lyucaatl mipidaer bc/ 'sit tcu eboefr ti can t"fl.uo".toa.w tsela is't eth onyl way hsti mkeas nsees +4
suckitnbme  I aereg. I inhkt eht seointuq stem si iynasg eht pcssyeahttim wree edons.eil Not htta yeht wree era.spd +4


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