NBME 23 Closure of the mitral valve (NBME Answers)

NBME 23 Answers

nbme23/Block 4/Question#14 (reveal difficulty score)
A 61-year-old woman comes to the physician ...
Closure of the mitral valve 🔍 / 📺 / 🌳 / 📖
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+14 upvote downvote
submitted by ∗lfsuarez(160)

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tFsir rehat sudon S)1( is egernetda yb wot rhate levsa:v hte ilmtra leavv dan stcpudiir v.lvae yaleNr oslieutusnma snolgic fo sehet vasvle lnoarmly aegersetn a lsgeni S1 undso. lipitnStg fo eth S1 usdno si ahedr wehn timlra adn putiiscrd aevlsv ceslo at ylhgtsil nteideffr items, wiht ulsulay het ltraim ioslncg obfere idtrispcu

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yotsubato Then wyh the ukcf si ti ibgenircds a iarmlt velva nudso in hte iipucrdts raea +29

dr.xx 'its iergcbnsdi a gnipiltst S1 — tisnicsnog fo tilmra nad discirtup elvva ruceols — ahtt si ebst rhdae ta het cputirsid (flte lerwo rlensat oebrdr) nda tlamri ai(cdcar )eaxp sgienltni tso.ps +40

titanesxvi ykitrc ,eqnuitso I ouhthg thaw dsuon it si in hte eltf ternsla er,odrb so I hseoc csidtrpiu eva,lv ubt tawh thye wreeh nskiag sw,a athw is het rtsif mpenontco of het 1S onsud +5

titanesxvi ricykt ,iuoesqtn I huhogt hwat dusno it is ni eht telf strnlae rdoe,br os I chseo dicrsiupt lavv,e btu hwat tehy eewrh iskagn sa,w twah is het isfrt nopmnteoc fo eht 1S usodn +1

drzed It ns'doltuh ertmta heerw uyo hare a iptls snd.ou Fro ,eamxple no rtaetm hweer uoy uacausltte on eht ta,hre the ndesoc htrae sound ni a yhlahet vddiiuanli will wlayas be A2 tehn 2P hehwre(t ouy rae ta the rimtla tnilginse tosp or teh roatic sntngilie sheTpt)o kye is cniinzgeogr that het hrigt edsid evavls ni yelahht nidsiaivuld lwli aywlas eolcs laetr .(eg. eth rahte osdnus rea S1 S,2 tub emor lfpciesiyacl M1 T1 A2 .P2) ehT orenas orf itsh si plimes: if yuo kate a tabrhe ,ni ouy illw enraisec rdpaeol on eht rhtgi ides fo the ,trhae dna stuh eht aetgerr elmuov lliw eacsu a deadyle clureos fo hte eavl.v Tihs is ghyposoiicl gtisinlp,t nda si rettbe aceedpritpa in the mraypounl dna atirco elsvav eesaucb htye are ruedn reergta uesrsepr, and tuhs e,urlod but ti anc laos be ahder in eth fsrti hetra .undso +16

alexxxx30 sye !eegdr!a Tshi uqenisot is smtoyl iangsk fi oyu rnustdaend a wfe iasbc gisthn rednggiar aroicd p.iosyh eTh letf eisd of hte rhtea si teh hrhgei rseuresp esdi os tfle ddise vsalev wlil lecos .tfris The rtghi esid fo het ertha si eth olrew ueesrpsr ,dsei hcwih nesam hrgti sdeid selavv lliw oenp ifsrt. [efLt lsosec frist, tgRih osnep ye]fs..r.,inctodlS ti eirsqreu ouy ot nwok twah S1 adn 2S noudss meco rm.fo 1S si eth rmla/itctiisrpud avvel gcolisn nad 2S si hte nyuaoc/ltmiArpor savvel nsc.ligo So erally the qiteunso assk twha si hte rfsit peoocnntm fo S1 tlam(ri or tcsdriiup eslcos .si)rft Adn nceis ew onkw hatt eht flte ides lilw ylwasa lceos ,trfis ti tmus eb amrtli vaevl rcuos.le oSyrr fi htta saw a logn axntae.inplo +16

jesusisking hTsakn axex3xl0,@x yuo eht m!na PRI Koeb +

yesa @dzerd usnlse st'i ixdparaclao ttilpsnig x]E rocait tssoines, thne ti si coaitr elavv ogcsinl itfrs ta 2.S +

This video explains it https://www.youtube.com/watch?v=kvQ2IU3ILRo&list=PL3n8cHP87ijDnqI8_5WQlS4tN37D6P4dH&index=8&t=52s

+/- uasid(68)

I think by 'left sternal border' they're referring to the Erb's point - left 3rd ICS on sternal border.

Even I got it wrnong thinking tricuspid area is being described!

+/- abhishek021196(119)

+4 upvote downvote
submitted by ∗gh889(154)

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Gtare dovie on 1S nda it's !ilspt!

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+3 upvote downvote
submitted by ∗rolubui(17)

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hTe ywa I mebrmeer i,t S1: aMitlr &pma; utprsicdi cb lbodo egso fmor ratia ot eclrvsiten tneh rmof rvtlneecsi ot eouitsd the rhate &-tg-; S2. oNw, wneh uyo veah a lStip S1 teh ywa I tnkih uotab is ttha newh uoy anlhei you evah erxat bodol cmgion otin the tighr isde fo teh areht os het tcsdrpiiu aelsvv eolssc rteal adn eassuc a pislt 1S unop eisrap.irnot Heop that shlpe.

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: iptSl S1 rahde voer tfeL nlrstea rbdeor - psriitucd aa.er rtiFs tocnpmoen fo ?1:AS htgynina (MC ni )BRBB atht cesaus yaedlde elurcso of ruidscipt vvlea rmedaopc ot rmital ev-avl wlil aeusc lpist S1 thiw addeyel T1 nda realy 1M radeh at Tciiusrpd arae.

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+1 upvote downvote
submitted by usmlehulk(7)

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Pseela dera eth aslt ennseetc of teh u.i ntsoqe I nktih hte tlisp himtg be bseaecu of ,.bbR this esausc eth alrtim dna ucsitpidr vlave to scoel at tdereniff ie.tms

os- hwchi of eth illfwoogn sebt alexsnip het ritfs ocnotnpme fo het trahe usdno tips(l 1S.) lou hdS eb hte imltra avevl ecsluor eofebr eth idcptrsiu aelv.v

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