NBME Answers : centeno's page

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+1 visit this page (nbme24#13)

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I thought that the cognitive impairment could be the manifestation of neurosyphilis. In addition, the doctor should talk directly to the patient to check for sexual abuse.

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j44n The maximum MMSE score is 30 points. A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer's declines about two to four points each year. she only has mild dementia. I had to look this up she could still retain her capacity +1

+2 visit this page (nbme24#47)

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The patient asks about the most effective treatment. FA 2019 page 642: Copper IUD = long-acting reversible contraception, most effective emergency contraception. Although FA refers to emergency situations, maybe the word most effective is the clue.

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submitted by neonem(629), visit this page

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My best guess is that this patient has a bicuspid aortic valve and has a murmur due to increased volume overload from the pregnancy.

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charcot_bouchard Can be congenital mild Tricuspid stenosis also. it also exaggerate during preg +

wowo probably just a flow murmur, https://acpinternist.org/weekly/archives/2017/05/16/3.htm +9

noplanb Wouldn't Tricuspid stenosis be a systolic murmur? +

noplanb I mean diastolic* +1

centeno I think that a murmur of grade 2/6 is a clue for flow murmur. Maybe any pathologic cause of murmur would be exaggerated in pregnancy (due to increased blood volume) +

srmtn "Although a heart murmur and ankle swelling may be associated with heart disease, these two symptoms also may occur during a normal pregnancy. Nearly 90 percent of pregnant women develop a heart murmur, which may be due to the increased volume of blood flowing through the heart during pregnancy." +