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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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tAilrtenoa of the sihmoctertat est optin is a mlpyotiahhca speorsc taiededm yb nsngorapitasld nad si enpendeitdn fo teh cmpyheattsi onvuser ytmses.

,B C, D, nad E lal riuerqe ctsipmyetah rnseve ot ltieilc a rneo.esps

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pg32  nCa onyane xeinlap het miheanmsc ibhedn nirhivsge adn teh tistaehmycp noverus ssyt?me +4
mdmikek89  haypHuomslat serlya thuhrgo hte oitomacnu enrosuv mss.tye ouY tcu eht ,lryae uyo anc yonl neachg hte stitarchemto tse ti,pon ubt eth dboy na'tc ra.ect +1
umpalumpa  uGsy, I ihnkt taht rfo teh eiivgrhsn vttneerliaa eth tinop si ONT atht ichtetsypam nresve oroctln nhvsgriei ca(ylla,tu I a'hvent ounfd raclesit no uempdb ttha asys ahtt gsvihiner is nlroelotcd by eimsyta.tc)hp THe stieesa wya ot itnkh is htat thsi tp sha a ecmstsiy fiocneint a(ak RSsem-StyIcis fanrayoilmtm eepsnsro rnsoemyd). nI ,SSRI tp nac aehv 3l5;T&t C or ;g3&8t ,C TBU ti si ermo ommnoc to hvea efrev ntah e.poyhathirm Csdnornegii ,tish yuo can ilasye -utuleor eth gniesvhri atirnta.elve +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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opslHhaatyum clroltgnnio emrtuaterpe ets pniot si rilybfe imotenedn in ataoPmh 8120 toiedin peag 3,1 pCethar 2 III ladrinCa gsnsi fo aomnntaimlif D. erevF

Pogesney &-g;t gehoacpmar releesa 1I-L nad NFT t&-g; edransice seoycgoacnxley atictviy in tmsyphuoaalh epualrcvrisa sclel -g;&t drcaeensi ohpsyulathma GPE2 gt&;- risaed emperttuera set intpo

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 +0  upvote downvote
submitted by gribear(0)
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Can mesooen ilxpaen why nwhe uyo rtcnetas teh slinap crdo eusrriop to het ellve fo ieymscttpah lfotouw -- nad uoy gte a ystecmsi enctioinf -- eth rpoesesn si itnlrateao of teh cmietttsorah ste t?inpo

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its_raining_jimbos  So I secho that eno bcesuea set npiot si lrndoelcto by het yhutpoasahml (E2GP adn 1I-L aieetmd vrfee ni teh ula)tyhoahspm adn the rest fo teh nserwa ochscei ndilvvoe smogheitn webol eth lleve atth hsa bene adett.ersnc Nto 010% srue if hattsโ€™ auteaccr ghtohu. +5
noselex  rgdAee iwth inbji_ism_irgtosn@a -- evreF si tadidmee by alrgietn est ponit in saatmholyuhp. lAl het toreh oshc,ice as arf as I can te,ll noevvil steimtpayhc rnseev adn rtihe fstfcee ta tergat osg.arn +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 ihts qentuios ,gonwr btu i tnkih wtah htis usenoiqt si yreall sniakg is htaw nepphas in a csimtsey it:oncfnei hhciw si evref

in ycmsetis fto,neicin het stmo ibuovos sign ot okol orf is a fve,re ton ilencyerssa genvsriih, eg,wasnti eaht tuodpocnri by wobnr ft,a c.et

nad ohw sedo fever ocu?cr eilk omeeson daalery end:inetmo peesyogn -;g&t- coemasgahrp gsierenal L1I nda FTN ihcwh ssneiarce OXC tctyivia in smhahaplytuo rvipaaerlscu lslc,e ceniears ucndropiot of 2GPE ni aosumaphtlhy dna teers teh tertupmerae tes in.top

i kntih hte hleow rephsa teocpmel" irenatontsc of the nipsal rdoc irrpoeus ot hte vllee of es.yahti.pm".tc si a nao.ttciirds ti ustj llste yuo hatt otnvdmeelep fo a evfre sah ihongtn to od hwti it

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j000  enmlevdetpo fo a vefer ni syetscmi fincienot hsa tgohnin ot do thiw tyhcamsiept unverso lf,ow os enve tis' jiedn,ru fvree loudw ltils ccu.or I hknit stih nuotiesq is tsju iknags how sdoe evrfe urcoc ni faeinmtlii/cooimtafnnn snai.ttuio +1
b1ackcoffee  oS, woh do yuo axeplni teh culaat feerv yb utjs inagnchg hte ht??etmroast eFerv tc''feef IS denru teticymahSp olnor,tc tsuj the ngagnihc eht paeutreertm lki(e meat)rostht is aimededt by ksityceon adn usaoyhtlp.ham +2
j000  oh i ese awth yuo em,na well i int'dd onkw htta, so shtakn fro cfilgainry a.tth e,rowhve based no royu oaaentxnlp,i it olwud lstil etg su ot het trgih srenwa cihhw si n"tlieaator fo iorcsmhteatt ste ,pn"oti otn teh reevf tefefc ef.sitl +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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Oayk yosb and gsrli tsih uetqsion is aeiser htna oyu ikhnt.

aayolHhsmupt lysear iva het phmtycastie ueronsv ystmes to lronotc eth yodb hnwe a wen set onipt as nebe rheeadc in etls .saeeac.esf.vr.y.u. ..obi.e.ntci.yfn

If hte enoitcncon eenbewt eht yamhhasotpul dna lnsipa ocrd ilnyma( eth tpsaiyhtcem toluw)fo is ct,u eth atulsamh tnacon ylare hte oydb iatcoren fo a ,vrfee utb eth pmasyutholha itlfse can tlsil aencgh eht set opn.it

ooBm

iihntW teh ,rniba the nauimooct nsvrueo esmyts si aegdurtle yb eth ultopy.haahms cnmiooutA uinnotcfs nedluci noocltr fo tar,orisnipe ircacad ontgaeirlu (het rcadaci nrocolt rct,en)e otrmvoosa vtiyicat ht(e rmoosoavt ,rteenc) nda eraticn rxelef citsano chus sa u,gngiohc szn,inege lonswlgiaw dna ivgnoti.m

BE- cocru as a uelrst fo a anghec ni tes iot.pn

A ephpans ot cueas het EB- hwne a new set ponti is dehc.era

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI syeimsct ticnfieno, t'udolnw uoy gte eostuncau LIAIasvNTDOo e..(i vubetiirdits )hokcs? Tshi wsa my agnersion for nosichog B) ni isht wykac oueqit.sn

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neilfespiritu  ameS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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rFmo oyonkrHhdoaeSkneu no ite:ddr

aWth the uotqseni is tngigte at is hte meshyapitct iahcn was read.ps It saw a elrretib awy of gordiwn ti.

rYuo nreoatri amphyotshalu is besilnpesor rfo gnolioc aseuetfr nad si urend tiamyehaascpprt l.cronot A loeisn wodlu caesu epya.mehrtihr

ruoY opisortre hoayultmhasp is rsinlbeseop for iahgten nhew oy'uer dloc dna to ngeetrae hte eevrF onesrpes dan is eunrd ctmahpsiyet .olocrnt A elisno udwlo caues mieorpha.yth

In thsi neisquto ti si pyslim kiagsn a pnosre gtse ks,ic hpmalyauhtso aws edp,rsa hawt hea.snpp

newsAr: alhomthaspyu llwi sllit eb able ot aeetlev ste yodb trprtuaemee ot bttlea .tcoenniif

tn:iH IF hyet giev a ostieuqn salrimi ot shit btu rdeewrod to eicdlun a lsioen fo eht icpyamttesh esfbri ro of teh hos,ultahypam yuo owdlu ni nurt OTN eb ealb to egeanrte a reefv sesneorp to coni.ientf hTe thshaylumpao dluwo be reyelitn rnued etcrmpsahiatpay oronclt

sThi adsd mroe xttneoc to hte ctfa het Q sstate ahtt eht saspetcymiht saw psrdae

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oslerweberrendu  ,So thsi assy tmyhiatespc saol sarpde adn atmhoualphsy sloa e.dpsar hTen wtah aws ownrg htiw itsh alcliicn s??ace +1
adong  i ktnih eht esmypttihca smtesy is uayltlac peiidrma /bc sit' tcu beerof ti nac fl..t."awouot" eltas 'ist eht yonl yaw itsh aekms nesse +4
suckitnbme  I .egear I tkinh hte itsunqoe mets is nyigas het tmisshyeptac ewer ideoesnl. Nto ahtt tyeh eerw rasdp.e +4


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