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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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leattonAri fo eht icromtehatst ets poitn si a cyoalhamhtpi rspscoe mtadeied by idrgtspoansanl dna si tneidenndep of the acttpsymihe noesuvr mtyess.

,B ,C D, adn E lal uiqerer ehtpismtcya rseenv to ltelici a rssee.nop

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pg32  Cna noynea lixpnea eth eniachmms edhibn girhinvse and eth semttyhicpa ursevon symte?s +4
mdmikek89  Hhysutlaapom arelys hurthgo eht ocomitanu eorsvnu tes.sym uYo ctu the raye,l uoy acn lyon gahecn hte tmtoctieahsr ste tniop, tub eht bydo tc'na tcra.e +1
umpalumpa  Gus,y I kntih htat orf teh hsregvini earletnvtai eht nitop si NOT atht pyiatstemch rnesev clrtono srvngheii a,uylc(lta I e'thvna ofund cteialrs no puembd taht syas atth sgirevinh is elocnotdlr by ).ptcmhiseaty eTH saeteis yaw to inkth si that sith tp hsa a tysemics ieocinntf aak( ciSIetyS-Rssm maanfytrmloi erpsoens odsr.nym)e nI SRS,I tp cna ahve tT&5;l3 C or 3t8g&; C, UTB it is meor oomncm ot ahev everf nhta rhi.poyteham esninrogidC thi,s yuo nac aleyis uelur-ot eth rvihesngi ter.itvaealn +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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thmoaaspuylH olcngtolrin mteratureep ets pntio is lyrifbe nmeeonitd in Pathmoa 0812 ntidieo egap 3,1 tCrphea 2 III aldnriaC sgnis fo amnlfmtioain D. reveF

eonsegPy -&g;t hpgecamrao aserele 1I-L nad FTN -&t;g dieenrasc eecsynlgoyoacx iactytvi ni aahhtomlupys ursvcraiaelp sllce &;g-t sdnereaic hhpuoysmlata E2PG &;-gt asrdei ueerarttpem tse piotn

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 +0  upvote downvote
submitted by gribear(0)
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nCa noomsee planxie hwy hwne you atecsnrt hte lsipna crod urproesi ot het leelv fo ymtehicspta ofwtuol -- dan oyu etg a icytssme nefconiti -- eth seroespn is rtilnetoaa fo hte eithastortcm set ipot?n

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its_raining_jimbos  oS I cheso ttah noe aebuesc tes ptnoi is oltonlrecd by eth ymaphsatluoh G2P(E and 1I-L eietamd ferev in eth )ohaauthsmylp and eht tsre of hte aerwsn ohcseic voivndel gsihotmen eowlb eht vllee ttah has nbee .edrntasect otN 001% seur fi attโ€™hs auertacc uhhto.g +5
noselex  gedreA twhi mijr@an_so_intsbgii -- eevrF si ditdaeem by gaerntil set nopti ni huy.hltspoama lAl eth otreh iochs,ec sa raf as I nac tl,el veiovln mictpatyhse esnver dna etihr cstefef ta ragtte sgn.ora +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 got tsih unieqtso rnwo,g ubt i kntih hatw tish isqnoteu si lareyl nsikga is awht pehapsn in a icymetss fiioctnne: hcihw is revfe

in cesimtsy f,noitiecn the otsm uvsoboi sgni to kool orf is a rfeve, nto escrsaielny irnh,evsig atgi,nwes thae irootndupc yb ornwb ,tfa ect.

dna who oesd fevre ?crouc klei emnsooe eyldraa :detmonnei gneeosyp -t&;-g msohercapag igrnseela 1LI nda NTF ichhw reinsaces COX atycitvi in sholaytupham prslvuraceia ,scell eaiscren driunotpoc fo P2EG in thosyalamhup nad tsere teh uereeatmtrp set ntoip.

i nkith eth lhoew seahrp oepemtlc" rocsitannte fo hte asplin crdo rirsouep to eht leevl of ..shpety.tma"ci si a ioan.isrcttd ti stuj stlle uoy that teeepvdmlon of a rvfee sah intohgn ot do hwti ti

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j000  poelntvemed of a eerfv in cteisysm fnioectin has nnhiotg to do hiwt empyctsihat enursov w,olf so eevn t'si njudeir, freve udwlo sllit cr.uoc I ikhtn ihts qusoietn is stju aiskgn owh edso refev ccruo in ciniono/mmnentafaifitl tsuionati. +1
b1ackcoffee  ,oS woh od oyu xaielnp the lacaut verfe by utsj ggahcinn the tematot?rhs? vFere ''ceteff IS rneud ycSemipthta lncootr, jsut hte ghacginn hte emrtrepuate ekil( arhttsetm)o si adtiedme yb cntykoeis dna m.uaypahhsolt +2
j000  oh i ese hwat uyo ,maen well i dndit' know tath, os hnksta rfo cglyifinra .atth ree,wvoh dbesa on uroy ixlaanp,oent ti dulwo lsitl tge su ot hte hrtig wensra chwhi is "otarlnitae of tesichttroma tse t"o,inp ton hte vefre etcffe ie.sltf +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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ykaO osby adn islrg isth isotqneu si arseie ntha ouy hi.ntk

Hyuptshamoal slyrae via teh eitpcthyams sreuonv sytmes ot ornoctl the dboy nhwe a nwe set ioptn as eenb eredcha ni stle .s...eseu.ve.frycaa n.tfbiei.o.cn.y.

If teh nnenioccto netwebe hte tamuhhplsyao dan plinsa dcro layi(mn teh tmtscpeiyha woftuol) is utc, the lautmsah ontcna ealyr the doby ecoanrit fo a vrfe,e but eth ophylsuatamh ftelis can ltisl caheng hte tes pt.nio

Bmoo

niithW teh a,ibnr eht oouanimtc nouervs eytsms si galteeudr yb the hpht.aomsualy nitmouoAc ciofunstn ulcined roctoln fo oi,eniaprtsr cardaic iroelagtnu (hte cciaard nrotocl rete,cn) sarmovoto itvctiay eth( toorsovam rt,ee)cn nda cetiarn xrelfe sacoint cush sa ,iochuggn ienzn,egs lisolwagnw dna i.gnmiovt

B-E oucrc sa a rltues of a neahcg ni tse ptino.

A hpeasnp ot eucas hte EB- wneh a nwe tes ntpoi is hed.cera

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI seytmisc ocninfit,e noludw't yuo egt nuucsotea sLoIDAvaITNO .e(.i iertitbudivs )okc?hs isTh asw ym noiarnseg ofr oosgicnh )B ni hsti wycak nsoti.que

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neilfespiritu  eamS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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roFm khoernuayHSndoeok on teddr:i

thWa the souqntie is geigtnt ta si the emaspticyht nhica swa p.asrde tI saw a ebrteilr yaw fo wnrdigo .ti

ourY ratirnoe smhhlyaputao si nrpbsleoies fro icngool teeufasr and is dernu iypastahrpmacet t.onorlc A loesni uldow csaue yhmtrepaeri.h

orYu tiropeors umyhhoslapat is lopsenbiser rof tehgnia ehwn 'yeour locd nad ot aeeergnt the erveF psoseenr adn is denur yhttmipecsa t.locorn A snloie loduw eusca hmyapitorhe.

nI sthi ueqnosit ti si slymip naigks a esponr etgs cks,i ophtahuymsal aws d,parse wtha nhpas.ep

rAnwe:s utpohhslaaym lwil tslli be eabl to eeelavt set body trueapeetmr to etltba enioc.fitn

Ht:ni FI they egvi a qsnoiteu simrlia ot tsih btu redwdore ot nlcuied a isneol of eth maesthctiyp brsfei or of het myhapuahsl,ot yuo lwuod ni turn OTN eb leba ot ernegeta a eevrf sprosene to .nefnoctii eTh hsmuotaahlyp uldow eb lneriety eudrn cmshttayaaprpei oroctln

Tshi adsd omre etcoxnt to hte cfta het Q asstte tath the ihmspctytesa saw arpdes

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oslerweberrendu  ,So hist syas yametthcspi oasl rdepas nda uyaahhlosmtp aosl psaerd. eTnh tawh was rowgn twhi siht clnilica cea?s? +1
adong  i hknti the ttmyiacpseh emysts si allcauty iperaidm b/c st'i utc bferoe ti nca o.."wf"lu.toat stale ist' hte ynlo yaw tish skmae seens +4
suckitnbme  I are.eg I tinkh het nstuioeq tesm si iaysgn hte pceasthmsiyt ewre ednelsio. otN htta they ewer dsa.epr +4


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