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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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alnrtAteoi of eht toaehtrcitsm tse opnti is a halpmathoiyc speosrc tmdaeeid by ndtlaagpsrsoni nad is neepindednt of eht ectmtshaipy vuroesn symtes.

B, ,C D, dna E all euiqrer pecmthsytai eersnv to teillci a epso.nres

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pg32  naC ynnoea xpliane het immescnha bdienh hvsgreini dna eht icypmathset usevnor syem?st +4
mdmikek89  lumtaHpoashy elsayr hutoghr the iotnmuaoc sronuev yssme.t oYu cut teh ylrae, ouy acn oyln cnehga eht sectoatmthri tes p,inot tub eht doyb nat'c .etcra +1
umpalumpa  yG,us I hinkt tath fro eth hsireving aelenaritvt eth iopnt is NOT htat ycpmhetasit ernsve ornlcot inevgsrih yclaat,lu( I ehat'vn fondu selartci on dubmpe htta asys ttah rsvhignie si tdleocrlno by mipahtst.yc)e THe taseeis awy to tnhik si that hist pt hsa a iysmscet ntfecnoii a(ka estcSi-mIsRyS rmyafmtnloai epsorsen od)myners. nI SRSI, tp nac hvea 5l;3&tT C ro g;&8t3 ,C TBU ti si eorm nommoc ot haev refev ntah iy.mohepatrh oeigndCisrn thsi, you anc sayiel etrlo-uu teh iigrnesvh te.lntaeivar +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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amthHyulsopa cglnionrtlo tpteerrueam ste noipt is eybrlfi onedmneti ni atoPmah 0182 tiiedon apeg ,13 rpethaC 2 III Cadrlnia sgins fo ftnlimmnaaoi D. vereF

ePonsyeg -t;g& cghoamarpe lerease I1-L adn FTN -&tg; cranesied oecsycegnlaxyo itaiyctv in ohumayhltpas avipscularre lescl &g;t- enacrsdei maylsaphtuho 2EPG g-;&t dreasi eearmuettpr ets opitn

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 +0  upvote downvote
submitted by gribear(0)
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aCn esomone inapxel yhw hnwe oyu cntstrea the nasilp rdco rorupies ot hte vleel fo iyasptmthec flotowu -- dna yuo etg a sictysem niecoitnf -- the sepeonsr is nrelotiata fo eth cmesotrttahi set ?ipotn

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its_raining_jimbos  oS I oeshc htta one csebaeu est ptnio is lolndocert yb eth uhtmysaaolph G(E2P nda 1LI- etmedai evfer in eht a)hulophmsaty dna hte ters fo eht nasewr oseccih onldvive nsomitegh owlbe teh elvle thta ash bnee nrctsat.ede Nto %001 seru fi tโ€™tsha uctarcae ghu.hto +5
noselex  eAgder tihw i_ssi_rgbimni@ojtan -- veeFr si etmdedai by gtilrnae est otinp ni .tulasaypohmh All teh rheot eiochcs, sa raf sa I can t,ell oinlvev ieypstmcaht rvseen nad irhet ceeffst ta ergtat rso.nga +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 tog htis isoqentu won,gr tbu i hitkn thwa tshi instqeuo is lalyre ngikas is whta hnppesa in a tcseiysm cetnni:foi wcihh is vfree

ni scyistme nict,onife the tmso bvsouio ngis to loko fro is a vf,eer tno snlycasriee irnv,ieshg gsinew,ta taeh nuootdpcir by nwrbo ,taf tec.

adn owh sode veref ?roucc like monoese ryeaadl it:nedoenm ygenpose -tg-;& ogashmrapce lgiserane 1IL nda TFN hciwh rncssieae XOC itivaytc ni stuhyoaphlma iprvarsacelu ,eslcl renceasi dcoutoinrp of EPG2 ni hsyualahtopm dan tsere eht muerpretate tse in.tpo

i htkni eth owlhe rhpsea e"mtceplo riaecttnnos fo teh plnais dcor preosuir ot hte elelv fo peht"mc.tayi.s. si a toaitdc.rins ti tjus estll yuo tath tmdpelveoen fo a rvefe hsa gnitonh to do tiwh ti

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j000  enedoemlvpt of a feevr ni scimteys initnofec sah ionnhgt ot do tihw ypiacesthtm ruvoesn flow, os veen 'ist uidjnr,e rfeev dwluo tlsli rcocu. I ntihk ihst tinsqeuo is tsju nigska how osed eferv curoc in fnniomttc/nilaoefainim stniiu.oat +1
b1ackcoffee  oS, how od uoy enxpali teh lutaac rfeev yb sujt ngcaingh hte a?tehost?rmt Frvee ef'c'fet SI denru htypicSaemt o,rnclto jstu hte gcnhgian eht eetrmaetpur ik(el rtmtohsat)e si ateiddme by iescontyk adn lupsmaah.ohty +2
j000  ho i ees hatw ouy ena,m llwe i 'inddt wonk ta,ht so htsank fro rialfcgnyi hta.t hw,reveo sebad no yoru anilnoax,tep it uldwo llsit tge us ot het rhtgi wnsear hiwch si reaat"intlo of tsmcoeihattr tes i",pnto nto eht efevr efftce .iftles +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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aOky obys dan sirgl ihts ieotunqs si seraei htan uyo htik.n

yuapHahtslmo ylears iav the itctsayepmh runseov ssetym to ctoornl het doyb nhwe a wen tes nopti as ebne hraeecd ni stel eyru....svee.fac.sa nfcbi.yie..ton..

If teh cotnnconie beweten eht hatlmuyosaph dna npalsi orcd myia(nl eth actiehstpym utoflo)w si ,utc teh saluhtma canont eyrla teh dyob erncitao of a feerv, tbu hte slhyuomtaahp tslfie cna llits ahecgn eht ets n.iotp

oBmo

intihW eht arni,b teh tuciomaon eovunsr mseyts si eldteagru yb het atuph.laoymsh oAiotncum nstcfunio icdneul torclno fo rn,ipitesroa adaricc etiralgonu et(h drccaai rltcnoo ne)crte, vsmootrao aivtitcy t(he oaosomvtr reen,)ct and ceratin exelrf ionscta usch as gugnih,oc n,zeisgen gnowwalsil dna igimv.ton

-EB ouccr sa a userlt of a hgacne ni set n.itpo

A nehapps ot scaeu the E-B henw a new set ntopi si he.erdca

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In esstmcyi nion,tecif notlu'dw ouy egt auuotsnec AoIONLvITsDa .(i.e tsiiibretuvd h)sck?o sTih wsa my ansgnorei orf ncgoisoh B) in siht ykawc qsetonui.

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neilfespiritu  aSem +1


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 -3  upvote downvote
submitted by โˆ—gh889(154)
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Form aodkkreHyoSnnhoeu no rdtde:i

ahWt the oqsinute is ggentti at is the apmsiyehttc nciah saw presda. tI saw a itbrreel yaw fo rdngwio i.t

Yuor irneroat paysotmuahhl si ilnspbesroe orf ogcnlio aesuetrf and is runde teyatcapirmashp nrlo.oct A osleni owdlu caues reahihepytr.m

ourY rpiersoot mohauyhsplat is lsbirnospee orf gnhieta wehn 'yrueo clod nda ot teanrgee eth eevFr oesnrsep dna si endur tsecyimhtpa oo.crntl A ieslno lwduo acsue yhohitpm.aer

In hist entquios it is lsmpiy nakgsi a srnepo steg cks,i ysaahthoumlp aws d,aeprs thwa sean.hpp

ws:enrA oashhlatmypu illw tlsil eb leba to aeevelt est ydob atutemrpere ot leatbt ftie.nicon

Hn:it FI yhet giev a stoeuinq armsiil ot shti btu orerddew to delnicu a lneosi of hte asiyctmthpe rsifeb ro of teh hyhapsu,tmloa yuo oduwl ni ntur ONT be albe ot ngeaetre a feevr opsnesre to nn.iteocfi hTe hlsytpahaoum udolw be nltereyi udren sthapmieaprcyat lornotc

hiTs dsda remo tnxetoc to het actf het Q esstat htat eth mycathistpse swa prdaes

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oslerweberrendu  oS, hist assy aicmheytpts sola sardpe and ulmhhytpaosa slao ra.desp ehnT what was gonwr tihw iths cnclilia a?c?es +1
adong  i htkni the mptscihatye etsmsy si tllcuaya peiirmad bc/ sti' tcu fboree it anc .tlofo".au"t.w stale 'sit teh loyn ayw ihts meaks ssnee +4
suckitnbme  I .gerea I nihkt the tseunqoi mset si isagyn eht thipmstacsye eerw ies.lnedo oNt thta ehty rewe .repdsa +4


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