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NBME 21 Answers

nbme21/Block 1/Question#16 (52.6 difficulty score)
A 43-year-old man comes to the physician for ...
Aortic🔍
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 +32  upvote downvote
submitted by mcl(501),
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dlLabee CRX hgoiwsn inioptos fo eetnriffd vs.vlae

hyperfukus  this link is great! they're still kind of close together :( its so hard to tell for me w/o reference of the others +  
hyperfukus  this link is great! they're still kind of close together :( its so hard to tell for me w/o reference of the others +  
mannywillsee  So the way to differentiate Aortic valve from the others is by checking the lateral view, AV will be more medial than both tricuspid and mitral; tricuspid will be more anterior and mitral will be posterior while Pulmonary is doing its own thing +1  



 +16  upvote downvote
submitted by step1soon(43),

https://radiologykey.com/valvular-heart-disease/

Look at where the cusps are pointing → upwards therefore aortic. if cusps were downward → then mitral valve would be the right answer

misterdoctor69  mitral valve would only have 2 cusps even if it were replaced though right?... +  
bbr  After staring at this for awhile, I wanted to elaborate on this to make it even clearer. The 3 areas that meet at a point would be the 3 cusps. These 3 flaps are going to get blown open. Means flow is from down to up. +2  



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 +2  upvote downvote
submitted by suckitnbme(113),

I was stuck between mitral and aortic and went with aortic because the L ventricle looks enlarged, possibly hinting that the patient had aortic stenosis.

drzed  I went with aortic because it looks like the valve has three cusps, while the mitral valve should only have two. Incorrect logic? +2  



This may be wrong, but it also looks like he may have had aortic regurgitation before. You can see that his has Left Ventricular enlargement.