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NBME 21 Answers

nbme21/Block 3/Question#46

A 38-year-old woman comes to the physician because ...

Patent foramen ovale

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submitted by nerdy nik(3),

DVT that went to the brain. If it would have gone to the pulmonary artery she would have a PE, but it crossed the atria wall via a patent foramen ovale and went directly to the brain.

cienfuegos  Some more UW info: incomplete fusion in up to 25% of adults: remain functionally closed until RA > LA pressure (e.g. valsalva), esp. concerning if hypercoagulable (e.g. OCP) -evaluate cryptogenic stroke with buble study: inj agitated nl saline and look for bubbles in left heart +