NBME 23 Answers : Block 3 : #22 = A 54-year-old woman with rheumatic heart ...

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NBME 23 Answers ↦

nbme23/Block 3/Question#22 (32.7 difficulty score)
A 54-year-old woman with rheumatic heart ...
Intra-alveolar transudates🔍
tags:

+6 upvote downvote
submitted by shaydawn88(7),

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sI ti rlaaetiona-lvr tntasseraud buecsea sthi npttiea gihmt ehav FH t/d .a ifb nad eflt atialr egnr;te-n&elgtam cni hydaictotrs -stee&;upgrsr ueatndtsra luraepl ins?uoffe

sajaqua1 Basically. +2

medschul Why can it not be arterial hypertension? +2

meningitis I think Arterial HTN is referring to Pulmonary Artery HTN which would be present in LT HF in the long run with RT HF and edema. Pulm HTN would cause a backflow, and doesn't really answer the question "explain the patients Dyspnea". At least, that's how I saw it. Hope this helped. +5

sugaplum the question has 2 murmurs, so does she have aortic stenosis too? i guess it is not relevant since it asked for what is causing her SOB +1

nukie404 I guess pulmonary HTN would happen in response to increased pressure after the edema happens, and would cause backflow (to the RV) over pulmonary edema. +

vulcania There's a really great diagram in UWorld (QID 234) that explains what happens as a result of mitral stenosis. Very similar sounding to the patient in this question. +

srdgreen123 @sugaplum, yes rheumatic heart disease can cause mitral and aortic stenosis. Rheumatic aortic stenosis can be distinguished from degenerative aortic stenosis by 1)coexisting mitral stenosis and 2)fusion of the commisures. +

+2 upvote downvote
submitted by dentist(40),

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ethcmuari hrt dz = iartml eiostnss = amlnproyu demae (ailblaret ceaks)lrc = nsadeyp

+0 upvote downvote
submitted by kimcharito(11),

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it si ramonl iadriaonrti to the TGHRI cnke? wtha edso it m?nea

krewfoo99 @kimcharito Aortic stenosis radiates to the carotids FA pg. 285 (2018) +1

-8 upvote downvote
submitted by charcot_bouchard(307),

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dlO udteetd aveh otrAci t.iesnsos tAilra totoinacrcn bmoece eseainlts orf tihs apttne.i so AS + bIFA si dguornsea uceeabs tsih uedcrse hte LV dplroea ylfintgciains nad tshi ttanpei dopevsle .HF So FibA in AS tiatpne deen ot rrcetoc timildeamey

aisel1787 she's not so old! stupid comment +