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NBME 20 Answers

nbme20/Block 1/Question#47

A 60-year-old woman with type 2 diabetes mellitus ...

Rupture of a papillary muscle

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submitted by hayayah(525),

The two most important MI complications that occur within a 2-5 day span are papillary muscle rupture and interventricular septum ruture.

Papillary muscle rupture leads to severe mitral regurgitation, heard as a systolic murmur at the apex.

dulxy071  I disagree. any sort of rupture is usually the result of the action of macrophages (to eat away dead, necrotic tissue) which come in on day 3. This was merely a word game to get the time line right. They said "TWO DAYS LATER" (keeping in mind our time line starts 16 hours after the first symptoms appeared in this stem) which actually turns out to be day 3 +1