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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rFtsi ahrte duons 1)(S si aertndeeg by otw rtahe lvav:se eht italrm vlaev nad sruipictd ev.val yrlaeN ulsasoituenm osgicln of eehst slvave yloarlnm gtaensere a lgesni S1 .nsduo nttpigliS fo het S1 sound si rahed nweh atimrl adn idpcrtisu aselvv lcoes at lygltshi fdfntreei s,mtei whti ylaulus eht imlrta lisncgo breeof ucpidtrsi

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yotsubato henT wyh het kcuf si it inbsrgcdei a irtmla vvael sudno ni eth sripctidu eraa +29

dr.xx is't gdsbnireic a isltgipnt S1 — snsnoitgic of iratlm nad ptisurdic laevv cuelors — thta is btes drahe ta teh pirtducis f(lte lwoer snltaer dorrbe) nda aitmlr ic(drcaa xe)pa niesgnlti ssp.ot +40

titanesxvi ytikcr qe,inuots I ugthoh athw dnsou it is ni eht ltef leasnrt redorb, so I choes cusidiprt el,vva but twha yteh eerhw kgaisn was, atwh is teh frits onpcotemn fo eht 1S sduon +5

titanesxvi iyrkct ue,itsqon I hugoth htwa ounds it is ni the ftle etasrln rob,der os I hcseo stpircudi lvea,v tbu awth tyhe werhe giaskn sw,a htwa si het ristf encotpnom of hte 1S sdnou +1

drzed tI 'lnsuodht mretta erweh you earh a iplts .usndo For xleaepm, on teamtr wheer ouy saaultutec on eht tar,eh eth csdoen ertah usndo ni a alhyhte ivildaiund liwl ysaawl eb 2A nhet P2 e(whetrh uyo era ta eht marlti nnsgiilet otps ro het atoric ngeiinslt ) tohseTp kye is econgngizri htat eth rgith desdi levvas in layehht usndadviiil lwil alaswy solec atrel .ge.( the hrtea sdsoun aer S1 2S, tub eorm aicsplyclief 1M T1 2A .2P) heT aeorsn for shit si iselp:m fi uoy atke a rhteba ,ni you lilw cnaeires poarled no eth thigr eids of teh rhe,at and htus het rategre muelvo lwil scuea a yedldae lrcuseo of the vale.v siTh is oigclhspyoi itnsitlgp, adn si bretet precpetadai ni hte auymlnpro adn caorit vaevsl cbauees eyht rae duern getrrae rse,rupse dna utsh ed,luor tbu it can asol eb edrha in het rifst aethr .donsu +16

alexxxx30 yes !ge!rdea sihT qnotsiue is mtlsyo knagsi fi uyo rasuddentn a wfe asibc ithgns ineggardr coirad pso.yih eTh tlef esdi of hte ehtra si the rhigeh ssuprree seid so tefl eddis laevsv lliw ocsle str.if The hgrti desi of teh rhtea is hte lorew rsrepseu sid,e cwihh enmsa hgtri sdide eavvsl will poen .itrsf Lfte[ slcoes ,sfirt giRth nosep .S.feydtsilr,.]cno it irrqeesu you ot kwno awth S1 nad S2 dssuon ocme mrof. 1S si teh di/mtlcsatpriuri eavlv sncolig dna S2 si teh tocmla/rpnuioyrA elvsva igosl.nc oS llaery the nistuoqe ksas hwat is eht frsti toencomnp of S1 tirml(a ro isidtucrp cseols tsir.)f dAn einsc ew know that het tfel deis lwil awyasl elcso ti,rsf it tsum eb iltamr levav socreul. rySor fi thta swa a lnog tilp.ananeox +16

jesusisking nsThak lx,x0@3exxa uyo hte m!an PIR boKe +

yesa dzder@ ssuenl 'its xradcoialpa pntgsitli xE] oircta niseotss, etnh it si cotria aevlv lsonicg fitrs ta .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(120)

+4 upvote downvote
submitted by ∗gh889(154)

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eratG eoidv no S1 nad 'tsi !s!litp

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+3 upvote downvote
submitted by ∗rolubui(17)

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ehT ywa I erbmmeer it, :S1 rlMtai pm;&a crstuidpi bc doolb oesg omrf iraat to crnetveils then form leetrncivs ot etosiud the eathr -g&;t- .2S ,Nwo when uyo aveh a ptiSl 1S the ayw I itnkh about si thta hnew yuo lahnei yuo ahev rxeta dloob mgocni onit teh tgihr idse of hte tareh os het pitirsucd vsealv cselos larte nda ueassc a tspil 1S nopu entrrpsiia.o eHop tath lsehp.

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+1 upvote downvote
submitted by ∗yogi(19)

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:Q iptlS S1 draeh revo eftL stlraen droerb - istircdup .raae tsFri etoopnmcn fo 1S:?A nntiaghy MC( ni RBBB) atht ausecs adedyle rluseoc of ciprdtsui vleva mdeoarcp ot ailmrt ve-vla wlli ausec sptil S1 wtih dlaedey T1 and arlye 1M readh ta rcsiuiTpd aae.r

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+1 upvote downvote
submitted by usmlehulk(7)

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sleeaP raed het satl eectnnes fo het qis.tu eno I ihknt teh lstpi tmhig eb busecae fo ,.bRb sthi acsues the lamrti and utisdprci lvaev to olcse ta fietrnedf .seimt

so- whhic of teh nwloiglfo etsb axilpesn teh rtfis nptmnceoo fo het arhte nuods pi(tsl 1S.) Slhud o eb het atlmri vealv usreloc erobfe eth prtiicsud ae.vlv

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