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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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tlrinAotae fo eht temiahstrtco est tnpoi si a aalopctihyhm orscpes teideadm by rssgnatidaolnp nad si nendtpedien fo teh hticsetymap sruvnoe steyms.

B, C, D, dan E all eiuqrer httaciespym rsenve ot ecililt a essoner.p

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pg32  Can noeyan xlnepia teh niesmhmca ebdnhi sgehnvrii and the tseyptaimch neusorv ym?sest +4
mdmikek89  plsmhyoaHtua reyasl ruhtgho eth atiucoonm nervuso ys.tmes uYo tcu teh rea,yl uoy cna ylon hcgean eht mshtettcraio tes nitpo, utb the ydbo ctna' .racet +1
umpalumpa  ,Guys I ikhnt that orf eht esnghiriv ieetnrlvtaa het point is NTO hatt piteastyhcm evresn rltoocn einivghsr tyl(ua,cal I avthn'e dufon lsaetric on mbpeud ttha ayss ahtt rinsgievh is rlooecltnd yb c)eymsphtia.t HTe aeisest ywa to khitn is tath hsit pt hsa a cymessit infcioetn aka( tRi-ssySIecmS rmmafilnytoa psreneos e.n)yosdmr nI SRSI, tp nca veha &Tt;l35 C or 83gt&; C, TBU ti si rmoe oommcn ot ehav rvfee tnah ayemi.hhrtop nidignoerCs tish, uoy nac esaily -eoltruu het ieghnsrvi aeearttilv.n +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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mHyasoathlpu tlrgnoniloc treptuareem tse ionpt is eblrfyi tedmeionn in Paamtho 1028 dieoint epag 3,1 Crtaeph 2 III ariCalnd gssni of iminmnoftala .D evFer

gensyePo -&tg; phreamcgoa sreeeal L-1I nda TNF g&-;t eadreiscn exolegsyocancy atyiivct in humyostahlap auverpiracsl cllse &tg;- adeeinrsc smhauotplhay EP2G ;-tg& aiesrd aeupttmrere tse ntipo

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 +0  upvote downvote
submitted by gribear(0)
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naC eosenmo epanlix ywh wenh ouy tractesn het psnail dorc orseriup to eht elelv of tyachpsmtei wfoutlo -- and yuo etg a msyctsie ieocinftn -- het eesprosn si nlaaitoret of het himcrtsaoett est pnit?o

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its_raining_jimbos  So I heosc thta eno usbeace set tiopn si lnoocldret yb teh tsualyhpamoh EG(P2 dan 1-IL mediate feevr in eht ahs)hlyptamuo dna eht ster fo eht arsenw ceschoi lnvvoedi smioength olewb het ellev thta ash eebn serct.nedat otN %001 resu if โ€™atsth racueatc htohug. +5
noselex  egAerd wthi @nmsgin_ijrb_oaisit -- erveF is dmtedaie by nraitegl ets tnpoi ni shpoauy.hlatm All the orhet coehic,s as far as I acn tel,l vlniove htyimptaesc nseerv nad heitr eescftf ta aettgr s.rgoan +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 ihst ueoisntq rwno,g btu i nkthi ahtw isht sunoqite is lryale aknsig is awht apspneh in a cymsesit fin:etcino hcwih si erfve

in ieysmstc nfenot,cii eth somt buvoios nigs to oklo for is a eervf, otn ciselresnay nihgvsr,ie sgnaiew,t etah crpdtonuio yb nrowb f,at c.te

nad owh oeds fevre cocr?u keil oonesem aralyde etmndnioe: neeoypgs &-t;-g crahpamegos aenelgsri IL1 nad NTF chwih iaenrsces CXO ttyavcii in uhaalpthmyso rilraaepcusv lsc,el aenirsec pidtcnoour fo PEG2 ni halshamotypu dna tesre eth eemuertptar ste npit.o

i nthik eht lhoew seraph oteclep"m ansrcitoetn fo eht siapln rcod oiprrseu ot teh eevll fo atshiycmp"..e.t is a aoniritsc.dt it sujt eltsl ouy atht etmveldnpoe of a erefv has gnhonti ot do htiw it

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j000  etemldnvpeo of a evefr ni imtcyess ietofcnin has goithnn to od itwh eyihtscampt vunreso lw,of so even 'tsi rjudnei, evefr wluod slilt u.croc I ihtnk hits iqstunoe si ustj saknig owh deos freev ouccr in ant/foliimneiitanncomf tiun.tsaoi +1
b1ackcoffee  ,oS who do yuo eilxapn het tucaal ervef yb tusj cinnggah eth mtasethtor?? vreeF ef''ectf SI uenrd pmhcaSyttie ,oloncrt sjut het ngngciha het trepuetarem (like seortthta)m is etadidme by kycontesi adn tmahhsloayp.u +2
j000  ho i ese awht ouy m,ane lwel i 'niddt owkn tt,ha so nkhtsa rfo gfrnyaiicl a.htt verow,eh dseba on ruoy aeipoxntn,al it olwud lsitl egt us ot the itrhg nswrae cwhhi si ntteoaila"r of oiettsamhrct ste tipn"o, ont hte eervf effcte teifs.l +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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yOak ysbo nda ligrs this niuestqo si eseiar atnh yuo ki.hnt

upytahalsHom esaryl iav eth ttpmhyaesci vnouser styems to colortn the bdoy hnwe a new ste ptnio as neeb eadrhec in tsel s.e..a.ev.y.efrucas yn...e.bcoift.in

fI the nncocetoni ebwteen hte asyhmtlouhpa adn ialnps rcod i(ymlna eth ttisyeahcmp ftuw)ool is u,ct the ltaahsmu nnatoc aeyrl the doyb antceori fo a rvf,ee tub hte olhtaaspyuhm ifetls nac tllsi ceanhg het ste opitn.

moBo

ithWin teh ib,arn hte ouocmtina usorven tsysem si degtuarel by hte omu.ylphhtaas uotAminco iocfstunn cednilu trcoonl of earintisrpo, acrdaci nrauogilet eth( adcrcia cltoonr )rent,ce vootamosr tiytcvai et(h toavomosr n),ceret dna creanti rfxlee tsconia ucsh as ,cgiuhogn neng,seiz alwnolwigs nad mt.ogvnii

BE- rocuc as a utrlse of a cgnahe in ets topn.i

A eahpnsp to uasec the -EB nwhe a nwe tse onitp si eedra.hc

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In cmssytie f,cintnioe ouwtn'dl ouy gte uusetoacn NOIsIAvTLaoD ..ei( isierdvtbuit hk)c?os hiTs wsa ym nenraigos fro gioohscn B) ni isht ycwak iuetqn.os

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neilfespiritu  aSme +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Form hnadeokSeunorHyok on dderi:t

athW eth uisqneot si tginget at is eth tpyeacihmst haicn asw sdreap. tI saw a tleibrer ywa of griwodn .it

uorY trniaoer aaothuhysmlp is sprbiolnees orf ogcionl ruefaest and si duern psmaryaphciatte t.oronlc A nolesi loduw esuac e.phryreahtim

Yoru opiterosr auypahhtlosm is slsbiponeer orf gaehnti wehn uo'yer ocdl dna to eraeentg teh rFeev rpsneeso adn si denur itesytpcahm rono.ctl A olnsei wdoul uecas mhypa.riheto

nI sith tsienuqo ti si lmispy gkansi a orpesn sgte sk,ic mlhatuyaspho swa asprd,e what phnp.sea

nsArew: mpyhuhlaasot illw isltl eb ebla to eeatevl ets bdoy epteemtuarr to lbetat iocnifen.t

niH:t FI yteh evig a nuqstoei irmisla ot isth tub erddwreo ot ndecilu a lesion fo eth emypcitasht esirbf or fo hte ohls,uptahmya uyo odwul ni nrtu NTO be blea ot eartgeen a eerfv osresenp ot ifecint.on Teh ystuhmpohala lduwo eb elitryne ndreu tpaaetmparihysc cootnlr

hsTi sdda oemr netctxo ot teh tafc eht Q astste that eht sepytscimath saw dpersa

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oslerweberrendu  o,S sith ysas htcytsapime laos sedpra nda shhtolmaayup lsao ds.erap hnTe tawh saw nrgwo whti hsit inillcac ?ac?es +1
adong  i tkhin eth eimcysthpat mystes is lauyalct imdpaeri bc/ t'si uct eeorbf ti nca lwotota."".uf. stlae it's hte oynl wya siht amesk nesse +4
suckitnbme  I age.er I nikht het oiunetsq tsem is sngyai teh sysiechtptma rewe dl.seonie oNt htta yhet rwee adps.er +4


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