NBME 23 Closure of the mitral valve (NBME Answers)

Retired NBME 23 Answers

nbme23/Block 4/Question#14 (reveal difficulty score)
A 61-year-old woman comes to the physician ...
Closure of the mitral valve 🔍 / 📺 / 🌳 / 📖
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+14 upvote downvote
submitted by ∗lfsuarez(160)

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trsiF aterh oudns (S1) si ngaeeterd yb otw rahte :vaesvl het ailtmr alvve nad rpcduitsi vvea.l rNelya snlesimaoutu nogcsli of eseht veslva lylnmroa tgernsaee a sgnlei S1 .donsu pintStigl of hte S1 sodun si eradh wneh rtmail adn icistrpdu vaevsl cosel at ilgyslth eedffitrn itmse, tihw sluyual eth iarmtl soncgli foereb usdicitpr

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yotsubato neTh hwy eht ufkc is ti sinebdicgr a mtlrai avvel donsu ni eht ritsuicdp raae +29

dr.xx i'ts csniibredg a ntpgsilti 1S — tnsigscnio of mrltai dna tusrpiicd lvave srleouc — ttha is sebt dreah ta eth uidpisrtc tf(el loerw lsneatr rrbeo)d adn imrlta (aaicdcr apex) ilnngtesi t.osps +40

titanesxvi yctkri iesoqn,tu I othugh htaw nsuod ti si ni the left lesnrta ,rrebdo os I cseho cridistup e,vlva but athw ehty eehrw snkgia a,sw tahw si het irfst nonoeptmc of eth S1 dunos +5

titanesxvi rcikty qnsituoe, I ohhtgu thwa uodsn ti si ni eth fetl nlersta r,edrbo os I shoec tcirpsidu vav,el utb ahtw ehty erweh nsaikg ,was thaw is hte frtis onpcmteon of teh S1 udson +1

drzed It hs'tdnuol rttmea rehew yuo hrae a iltsp sundo. Fro lx,pamee on martte rehew uyo aecaustltu on het rt,eah hte sodcne threa sndou in a htayhel aivdniuidl wlil slywaa be 2A nteh 2P thr(eewh oyu rae ta teh irtaml tgneinlis pots ro eth itraoc isgnelint etTsh)po eky is igioerzngcn taht eht rtihg ddeis elavvs in hlhyeat uiadvilsdin lilw waasly elcos artel g.(e. teh ertah dnsosu rea S1 S2, btu omre sfaiyelilpcc M1 1T 2A .2P) ehT sneoar ofr htis si i:smpel fi yuo taek a tberah ,in uoy lliw eaesincr paedrlo on eht irgth sdei of the r,eath nda shut eth gteearr vemolu llwi secau a ledyeda rueocsl fo teh vea.lv iThs si loyschgoiip tilnptis,g dna si rebett eratipeadpc ni the yruamolpn nad aitroc esavlv aceubse teyh era dnure reaegtr eresuprs, dna uths du,relo btu it nac asol eb aherd in the siftr ahert s.noud +16

alexxxx30 yse g!er!ade shiT uteqnois is toylms gksnia fi you dnntradseu a efw abisc ngstih gragnried cirado his.pyo ehT etlf deis fo eht earht is teh hierhg pesurers side os tlfe eidds aesvvl illw oescl trsi.f heT rihtg ised of teh reaht si het owrel surseepr d,eis hcwhi easnm irthg dedsi saelvv will pnoe rsift. Letf[ elsocs t,irsf githR speon yft,d.eSo.nsrc.i]l it ireequsr you ot kwno htwa S1 dan S2 nsdsuo eocm rmf.o 1S is eht amriipcstl/duitr avlev nlsoigc nda 2S si eht ociralnu/ompytrA leasvv nlo.sigc oS rlaley hte neistuqo asks waht is het itrsf cntoopnme fo S1 ami(rtl or piidtrscu eloscs rtf).is And nceis we onwk hatt teh tefl dies lwil swyaal coles fsrti, ti utsm be ritaml elvav oulc.rse rSoyr if ttha swa a glon etnioxa.alpn +16

jesusisking ahTkns x0l3ax@xxe, you eht n!am IRP beKo +

yesa d@ezrd nsluse i'ts daairxlpaoc ligitstpn ]xE ocatir stsoseni, hnet it is ortiac vavel cisgnol tsfir at S.2 +

This video explains it https://www.youtube.com/watch?v=kvQ2IU3ILRo&list=PL3n8cHP87ijDnqI8_5WQlS4tN37D6P4dH&index=8&t=52s

+/- uasid(68)

I think by 'left sternal border' they're referring to the Erb's point - left 3rd ICS on sternal border.

Even I got it wrnong thinking tricuspid area is being described!

+/- abhishek021196(120)

+4 upvote downvote
submitted by ∗gh889(154)

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earGt idveo no S1 dna 'sti !tl!ips

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+3 upvote downvote
submitted by ∗rolubui(17)

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Teh ywa I beemremr i,t 1:S lirMta apm;& dstupicri cb odlob goes mrfo triaa ot evnltceirs hent morf sievcnrlet to sideuot the ethra -t&-;g .2S o,wN enwh oyu veah a tpilS S1 eth way I inkth uabto si ttha ewhn oyu lahnei you aveh earxt oldob goicnm otin eth higtr esdi fo teh rteah so het cpdustiir lvseva socsel ratle dna ausces a siplt 1S upon .esroripntia epHo taht .pelsh

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+1 upvote downvote
submitted by ∗yogi(19)

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:Q Sptli S1 eahrd oerv Lfte atrnsle oerdrb - cisuidtrp a.era tsFir potcmneon of :?AS1 nniatyhg M(C ni BBR)B atth sscuea daydele sulcoer fo isurdicpt lvaev edrpcaom to iarlmt levav- wlli ceasu isptl S1 ihtw adeledy 1T adn elayr 1M aehdr at dpcuTsrii .eraa

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+1 upvote downvote
submitted by usmlehulk(7)

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lPeeas rade het lsat nctnesee of the oinq.uets I inkth eth ilspt ihtgm be csebuea of bb.R, isht ecssau het ltrami nda durcipits aelvv ot loesc at nfietrfed emt.si

s-o hiwch fo teh nfllwigoo tebs eixsalnp eth irtsf cnmoepont fo eht ather sdnuo si(ltp S.1) Sduolh eb hte tramli vlvae rlcosue fbeero eth rctipdius v.alve

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