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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srFti tarhe nudso S)1( is egtreaedn by wto rthae lasevv: eth tlamri elvva nda uicptrids vav.el aelyrN salotusinmeu clisgno fo these selvva nylalrmo snareeteg a sligen 1S .ousdn Stpligint fo eth 1S uosdn is eardh hwen litmar adn upirstdci vlesav ecsol at ylitlhsg dffreteni tm,sei twih uysulal het miltra gsoilcn rboefe piidurstc

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yotsubato heTn wyh hte ukfc is it bedrgscini a lmatri vealv ndsou ni het rcidustip aare +29

dr.xx tis' ridbicegns a ngpliitst S1 — ointssgcin of ilrtma adn iitrdscpu evvla srucole — thta is tesb hdrea ta teh tiurspcid t(efl lerwo tarslne obdrr)e adn riatlm rac(acdi ape)x ietnsngil stosp. +40

titanesxvi kiyrtc nutiqoes, I gohhut wath onuds it is in teh flet ealrstn rbedr,o os I escoh irdtsiupc vaev,l but thwa ethy weerh gaiksn s,aw htaw is eht istrf ecnomptno of teh S1 dousn +5

titanesxvi cikyrt osinu,tqe I hthoug twha oduns it si ni hte tfle tnlresa bero,dr os I coesh ucrtsiidp ,evalv tbu hwta htye hwere nkigas ws,a hatw is eth tsirf onecnmopt fo het 1S uosdn +1

drzed It oshdntul' aretmt wehre uyo erah a lptsi ud.son For xelamp,e on atetrm wreeh oyu tualusteac on eth heat,r the cosnde tareh nsodu ni a hylahte dvduinaiil llwi lsaawy be A2 neth 2P (etherwh uyo are at hte ilmtar sintilgen stpo or eht actiro isgienntl To ph)ste key si nocgrzgenii htta eth tghir sdedi vlasve ni ethahly nalidsuiivd wlli ysalwa loesc artle (.g.e eht ahter ounssd ear 1S S2, utb reom lpyasifceicl 1M T1 A2 P2.) The aronse rof ihts is msp:lei if yuo kaet a atbher ni, ouy will nscriaee delorpa on hte ihrgt ieds fo het haer,t dna uths eth arrgtee uvloem ilwl secua a yleddae rslecou of het av.lev ihTs si gopciylihso ngtlp,iits nad si tbetre epedcatrapi ni the aurnyplmo nad troaci vaselv acseeub yteh aer unred aretegr eusre,srp dan shtu oud,ler tub it nca olas eb drhea ni hte tfirs harte uno.ds +16

alexxxx30 sye eadg!e!r hsTi isqtnoue is ytslom kgisan if yuo aurdnnesdt a wfe icbsa ginhst agrrendig criado ps.hyoi heT tfel dise fo eth ehrat si eht herhgi sspurere sdei os lfet seidd vvesal ilwl ceslo fisrt. eTh hrgti idse fo eth athre is hte rwloe esurpesr ds,ie hhwic names itrgh iddes avslev ilwl nope .rsfti Lef[t ecsslo srtf,i Ritgh nesop rdo].f.Sie,yl.ctsn it euqsrrie oyu ot wkon ahwt S1 nda S2 dossnu oemc .fmor S1 si teh sialtrimcitr/pdu vlvea icslgon nad S2 is the /rocmynrtAaoiupl vaesvl nscoi.gl So ayrlel the siuoqent kass wtah si teh trisf nnctoompe of 1S riatml( ro sptcidiur lcseos rft.i)s Adn nesic ew nowk atth teh etfl eids lliw walsya esocl tsi,rf it msut eb atmlri vlaev e.lsucro oySrr fi htta aws a lnog nlnxaeiat.po +16

jesusisking sakhTn x,0lax3xex@ uyo het !nma IPR obKe +

yesa r@ezdd suesnl tsi' rdcoalpaxia piltsntig xE] toicra en,istsos enth ti is tacroi lavve ocgsnil tifrs ta .S2 +

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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taeGr deivo no S1 dna ts'i !tpli!s

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+3 upvote downvote
submitted by ∗rolubui(17)

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ehT awy I remmebre ti, S1: ritaMl ∓a cputridsi bc odobl oges fmro aitra ot elcevnirst tnhe ormf ervlntcsei ot oeiudts hte htaer --&g;t S2. N,wo hnwe uoy hvae a lStip S1 the wya I nthik aotbu si htat enwh ouy eanlhi uoy vaeh etaxr dbool ogncim toni the trhgi ised fo eht trahe so the udsipicrt lsavve lesosc aetrl dan asusce a litps 1S puon i.rornepatsi Hoep htta hlse.p

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+1 upvote downvote
submitted by ∗yogi(19)

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:Q ptlSi 1S darhe vroe Ltfe lstnear erdbro - iipsrudct rae.a sFrit mponcoten fo S?A 1: tnnygaih M(C in BB)RB ttha esusac adyeled eurclso of sdriciutp vvale rdpacemo ot iltram v-evla lliw ascue siltp 1S htiw lddeyae T1 adn ylera M1 edhar at dTrupiisc raea.

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+1 upvote downvote
submitted by usmlehulk(7)

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elseaP aedr het ltsa ntneeecs fo eht .nsouiteq I nkthi eth pstil tghim eb eseubac of .bRb, shit esusac eht arlimt nad udtisircp vaevl ot csoel at rndeftief imse.t

-os hwihc of the fiwoolgnl ebts pnalxsei eht itsfr enotcopnm of het aerth ndsou (pilts 1.)S hluSdo eb the lrtima aevlv sulroce oerfeb eth trcsiuipd vlav.e

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