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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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aeorAtlnit of eth ttemhiracost tse ointp si a yaahithmopcl psscore daeemdit by ptlginnssodaar dna si ndeetnneipd fo eht aystectmhpi unsrveo emytss.

B, ,C ,D and E all reiruqe hepctytmias srneev ot lltciei a seepos.nr

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pg32  aCn ennoay nielxap hte hamsicnem nebhdi nviihrsge nda eth hitpecytams veruson ymst?se +4
mdmikek89  ohyspaaltmuH aysler rguhoht eht tacouomni onusrev symst.e uYo uct hte ,yrela yuo can oyln hgcena hte rahiceotmstt ste n,otip tbu het dboy tcna' care.t +1
umpalumpa  ,syGu I thnki that orf the hnieisrgv ivateealtnr eht ntipo si NTO thta metchpsyait veesrn ntroolc ervignhsi ltyua,c(al I v'tneah fnodu aelrcist on emudbp tath ysas htta erhngvisi is noletclord by temictpsyh.a) TeH eetssia way to hitnk si hatt tihs pt ahs a imcestys tiifcnnoe a(ak icSt-ysIRmeSs mylroatnmafi sseeronp nroy.)msde In ,IRSS pt nac vhae t3;Tl&5 C ro ;3t&g8 C, TUB it si mero mcnoom to veah efrev tanh oiamhytpre.h egriisonCdn tsh,i uoy nca yeasil o-ruutel eht vihrsgnei aet.lnitavre +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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lthayopasmHu lnocltngior turtepaerme set noipt is eblifry nodetinme ni mhoPata 2108 onetdii apeg 31, hCatpre 2 III nriadlCa ngiss of itlnafiaonmm D. Fever

gosnyeeP g;&t- mpahaerocg slearee IL1- dna TNF -&g;t enesardci soagnlyxeccyeo ctivtyai in pytohaulahms sieavrpcarlu clsle tg;&- ceaidrnes ahlutyamposh EP2G ;&t-g arisde earrpeuemtt set onipt

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 +0  upvote downvote
submitted by gribear(0)
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Can nmooese elxpani hyw nweh yuo carttsne hte silapn cdro esriropu to hte elvle fo shmyatecitp wootflu -- nda ouy egt a esyitmcs cetnnifio -- eth psrseoen is ntaolteari of teh mthatorsceit set ?tpion

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its_raining_jimbos  oS I echos ahtt oen sebucae ets iotnp is oecnlrtdlo yb hte saluthymphao (GP2E nad LI1- eetmaid veefr in het )thmuopalahys dna hte rest fo eht wsrean ehoiccs ivovndle eomhntisg wbelo the lelve ttah sha enbe estartc.ned otN 0%01 reus if satโ€™th ccatraeu gh.othu +5
noselex  erAegd hitw oijin@nbigsa_itsr_m -- Fever is diedaemt by irtlgnea set topin ni yuahs.hopmalt lAl hte oethr ,ohcicse sa arf as I anc lelt, liovnve ptsycmitaeh vnrese dna rithe effctes ta trateg rgsnao. +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 iths ouintqes rgnow, but i ihtnk twah hist esinqout si elylar isagnk is atwh npshpea in a tscyseim cietif:nno hwhic si erevf

ni ytcmessi fi,teicnno the tosm vuobios sngi to olko rof si a e,fevr ton seelasnycri nseigi,hvr ne,wgisat heat curdpointo yb orbnw ,fta ct.e

dan who sdeo veref rocu?c ekil oeonems eylaadr ede:moinnt psgoeney -tg-;& orhepsagacm nlesgeira LI1 dan NFT whcih cenrsiaes COX ictaitvy ni hspyoatmulha cialvsuprear els,cl raicsnee uotdinpocr fo 2PGE in shayoaplmuht nad rtese het teprurteema est tnoip.

i itkhn eht eohwl ehsapr emepc"lot noctseaitnr of hte napils dcro rioprsue to the lveel fo c.ytit"ehpms..a si a dnitci.otars ti tsju ltesl uyo tath vmeeelontdp fo a eervf ash ohnnitg to do hwti it

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j000  vmpednetloe fo a refev ni itcyemss ofitennic sha gtihonn ot do ihwt ctmsehypita rvousne l,wfo so vene sti' jeuin,rd vrfee dluwo lilts cruoc. I hiknt hist niouqest si tusj gaknis who oeds eefrv coruc ni tmninoff/moltcnianieai ttasn.ioui +1
b1ackcoffee  ,oS who od uoy pelnxia eht aactlu eerfv by ustj cnggahni eht ??srhmeaottt Fvere eftcef'' SI edunr etSphityacm tcloo,nr tsuj hte nnggcaih het eeptteruamr lie(k ormtesah)tt si dteadime yb yntksceio nad smtplu.haoyah +2
j000  oh i ese atwh oyu ,mean lewl i idt'nd wkno t,tha so sahktn orf figaclriyn a.htt ve,hwoer bsade on royu pxianletnoa, it oduwl tisll tge us to hte htgri reswna wchih si atiolnra"et fo atesimtrhcot set ,i"npto not teh efrev fcftee t.fslei +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 ybos nda lgris thsi quenitos si aeiers tanh yuo ktnih.

aHlapoutsyhm rylaes aiv eth siteyahmpct nreosuv ymtsse to ortnlco het ydob enwh a nwe ste tpoin sa eben acrehde ni ltes vecea.ya...s.rseuf. .eci..bnn.tify.o

If teh occntneion ewbenet het tplmahuysoah dan nslipa cord aymnli( teh hpmteaistyc oltufow) is c,ut eht hsmltaau ocntan eayrl het oydb arenciot of a r,veef utb het ayusmatoplhh eftsil acn isllt ncehga eht ets i.pont

oBom

tnihWi eht bir,an hte imuoctnoa nurvoes mssyte is ldatueerg yb het ahtlsp.yohuma oniocmtAu icsoutnnf iedncul tlnoroc of ernstiapori, ciarcad ielotganru t(eh ciacdar rcolont ctn)e,re toasomorv civytait hte( saootrvmo etern),c adn niecatr rlxeef scanito schu as ciugghon, i,nnzseeg awlgilsnow dna mitog.niv

-BE crocu sa a lteurs fo a nechag ni tse nptio.

A eaphnps to euacs eht BE- ewhn a wen ets inpot si dc.hreea

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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nI symciets enctiin,of ow'nuldt you teg auuoecstn IDTOAILaovNs ie(.. iisvdttbreui ?csk)oh hsiT wsa ym ngeiasnro rof onshocgi B) in itsh cwaky n.iqueots

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neilfespiritu  ameS +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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morF kedruHonSokohnaey no e:drtid

aWth hte tsiueoqn si ngtetig at si teh stpytcmieha nciah was sed.rpa It asw a rblitree ayw fo irwdgno .it

ouYr rreotina ytsmphuahlao is sseelrinobp orf cgnoiol rafeutes dna is urden rapithatcsyapme ronltco. A loines udlow cesua trehhapem.iry

uYro terporios ohuytpsmalah si brnslieospe rof githnae hnew 'royue dcol dan ot geetaenr het ereFv essponre nda is erudn atyphiemtsc cot.nrol A eniosl wlduo sueac pmihoerh.tay

In isht isouteqn ti is ipyslm naigks a oesnrp tegs i,kcs yohhtsalamup swa erp,ads whta phep.ans

A:erwns ohlahtapymsu lilw lislt be ebal ot tleaeev ste oybd mruetaerpte ot elatbt contfieni.

nH:it FI htye giev a etisqonu saiimlr to sith btu erewddor to luniced a seinol of het aycipshtmet sfrbie ro fo eht ohtspahmau,yl uoy dlowu ni tnur NOT eb labe ot eegatren a feevr esspeorn ot ftncino.ie ehT puhltaosahmy wdulo eb ryneltie uernd rpiacypattehasm orloctn

isTh sdad eomr texncto ot het cfat eht Q setsat that eth hiayecsttpms wsa rapdes

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oslerweberrendu  ,oS hsit asys syctmthiepa aols rpasde nad uthaaylmphso sloa sprd.ea nTeh ahtw was ognrw ihtw iths cnilcali a?esc? +1
adong  i nhitk eht ysthaecitmp emysts is tllyaacu aiprimde b/c 'its uct erboef ti cna a.f"."o.tutowl etsal i'st het yonl ywa shti samek eessn +4
suckitnbme  I er.age I ihnkt eht nqetuios esmt si snyiga het yehsmtipasct reew in.edoles oNt htta thye wree .eradps +4


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