NBME 23 Closure of the mitral valve (NBME Answers)

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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iFtsr raeth sundo )1(S is eegdterna by wot taehr v:vlsea eht mtrail evvla adn ipcrudtsi vleav. ayrNel tmlsneuuosia incogsl of eehts alvsve malrlyon estnaegre a nilsge 1S oudsn. glptiniSt fo teh 1S suond is dahre nhew almitr nda isduptirc avelsv cleso ta tgylhsil efdtirfen tm,esi htiw suluayl teh iatrml cilgsno forebe dpturcisi

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yotsubato Tehn hyw eht ukfc si it ibrgciesnd a atriml vvael dnosu ni hte rsciutipd eara +29

dr.xx 'tis snbidegrci a tsiingtlp 1S — sotnngcisi of altimr and diupcrtis vleav olcseru — taht si setb erhad ta eth uipdcisrt tefl( oewlr snlater bodrr)e and lrtami aardi(cc p)axe lgisinetn p.osst +40

titanesxvi iryctk ,tinqoeus I ghohut hwta snudo ti is ni eht etlf tsnelra bero,dr so I ohesc tirscpudi ,vvale utb ahwt yteh heewr naskgi s,aw what is eht ifsrt omtnnpoec fo eth S1 ndous +5

titanesxvi tykcri steiqn,uo I uogthh athw nouds it is ni het flte srntlae erbdo,r os I hsceo trucdiisp valev, btu hwat they eewhr kgaisn ,aws hwat si the tfris nctooenpm fo eht S1 usdno +1

drzed tI tdnhuo'sl tratem heewr you arhe a plist osdn.u rFo leema,px no mtatre rwehe you elatcuatus on teh aert,h eht ocesnd ethra nodsu in a ehhtlay iludinvdia lwil aslywa be A2 enht 2P weht(erh yuo rae ta eth ralitm tsnglniei tpso or eth troaci nltiigens Te)toph s yek is zngeciornig tath eth irght sedid vvaels ni hehytla dudlsiaiivn lwli yalwas csoel terla (e.g. teh arhte ndsuso are S1 ,2S tbu rmoe ypclcelifsia 1M 1T A2 2).P The aosrne for tihs si limp:es fi ouy eakt a earbth n,i oyu iwll aceenirs aopldre on eht rghti seid of eth ha,ert dan tuhs eht reetgra omevlu lwli aesuc a dylaede uslcoer fo teh .ealvv Tihs is sliphyigoco tl,gtpniis and is rebtte percateiapd ni eth nlmuaroyp dna acoitr lasvev baucsee htye rae uerdn arrgtee rpesus,re and tshu l,druoe tbu ti cna olsa eb aherd in hte fsrti rhaet ndsuo. +16

alexxxx30 esy d!ae!erg hsiT seoiuntq si slyotm aksngi if ouy dsnterdanu a wfe sbaci tgisnh nreidgagr diaroc s.piohy eTh tefl sedi fo eht retha is teh ehhirg psreuers esid os etfl iedsd asevlv lliw losec r.ifst eTh irhgt edis fo het hater si eth olrwe rruspees esdi, hchiw sneam rgiht edsid evvsal illw poen sir.ft feL[t sesloc rifst, ithRg oenps ,ic.rSy]f.dsnlte.o it eqiuresr you to ownk wath 1S dan 2S ssnuod meoc .form 1S is het tlupmdrcraii/tsi alvve snilocg adn 2S is teh mr/ounloAytricap avelvs sigcnlo. So lryael the uineqost sksa atwh is het first cmnooetnp fo 1S mt(ialr ro drctpuisi slsceo .f)tris And cseni we okwn hatt eth tlfe sied lliw yawlsa elcso tfr,si it mstu be taimrl velav clue.osr Srryo fi htta aws a lgon ipealan.notx +16

jesusisking ksnhaT ,xxlx3ex0a@ oyu eth mn!a PRI Kebo +

yesa dedrz@ ssenlu st'i rdalcaaxopi tsgitinpl E]x icarto sonsit,es nthe it si oacrit vlvae lincsgo ftsir at 2S. +

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(119)

+4 upvote downvote
submitted by ∗gh889(154)

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Gatre odive on S1 dna i'ts i!tl!sp

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+3 upvote downvote
submitted by ∗rolubui(17)

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hTe awy I bemmeerr it, S:1 ilMatr p;m&a trucisidp bc lbood soeg fomr raati to rntsclveei then frmo lneisevrct ot uiesotd het earth -;>- 2.S ow,N when ouy aehv a ipltS 1S the awy I tiknh tbaou si atht ewhn yuo ainelh oyu vahe retax bodol mgnoci toin teh ghtir sedi of eht tarhe so eht ptiduicsr vesval oecsls ratel dan assceu a lpsti 1S pnuo ineorisp.art epoH htta lh.esp

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: Siltp S1 ahred oerv ftLe tansrel boredr - icisdrutp .reaa sFtir tecnpoonm of 1:?A S taygnnih MC( ni )BBBR htat eacsus ddaeley lcusreo fo irsdpituc alvev aorcmdep ot ilrmta -ealvv wlil scaeu lpsit 1S htiw eddeyal T1 and lyrae 1M haerd at psiiTudcr aa.re

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+1 upvote downvote
submitted by usmlehulk(7)

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leaePs aedr het stal enecnets of the ie noq.ust I ithkn eht psilt ihmtg eb ucseeab fo ,.bbR shit scause eth rmital and srciuptdi vlvae to scelo ta indteeffr seimt.

os- chhiw of hte fgoloilnw tsbe npelsixa eth tfrsi nectonmpo of eht rhaet douns spitl( )S1. ohdulS eb het limart evvla cseroul befoer teh ctpudsiir vl.eav

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