A 15-year-old is participating in high school football practice in August in Texas. He had complained of headache and nausea earlier in practice, but kept playing after a cup of water. He is now confused and combative. He is dizzy and sweating profusely. His temperature is 41°C (105.8°F). Which of the following physical responses is preventing his body from cooling appropriately?
c. Central thermal dysregulation
e. Autonomic dysfunction
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is d; Vasoconstriction.
Hyperthermia with dry, hot skin and mental status changes characterizes classic heat stroke, typically seen in the elderly with a gradual onset. Young athletes exerting themselves in a hot environment may develop acute heat stroke with signs and symptoms of hyperthermia and mental status changes; the difference, however, is that the athletes will continue to sweat profusely. The response to hypovolemia is vasoconstriction, leading to an inability to lose heat peripherally. These otherwise healthy athletes may be rapidly rehydrated with intravenous fluids, as they have a minimal risk of cerebral or pulmonary edema. Aggressive cooling is also required, with fans, ice water, and removal of clothing. Heat stroke can have a high mortality; prevention is certainly the best option, but prompt recognition is essential.