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NBME 23 Answers

nbme23/Block 3/Question#27

A 30-year-old man reports increasing fatigue and ...

Atrial septal defect

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Any time you see fixed wide splitting of S2, smash ASD.

someduck3  I'm not 100% about this so take it with a grain of salt. But i was confused about why there would be a systolic murmur. I think its b/c prolonged ASD would eventually cause pulmonic stenosis which would present as a systolic murmur. But besides that I super agree with @sympathetikey +  
need_answers  https://www.youtube.com/watch?v=7hzabZ7YBr0 -smash, smash, smuh-ash +1