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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#44 (reveal difficulty score)
A 62-year-old man has had the gradual onset ...
Tricuspid regurgitation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: cardio

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submitted by โˆ—step_prep7(71)
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  • Murmur that is loudest on inspiration = Right-sided valvular defect (tricuspid or pulmonic) โ€”> Location of murmur = Tricuspid valve โ€”> Holosystolic tricuspid valve murmur = Tricuspid regurgitation
  • Large wave occurring with S2 caused by blood aberrantly moving from RV to RA and up into SVC during systole
  • Eventually leads to RV hypertrophy due to increased preload (lifting systolic murmur of the sternum) and eventually right heart failure (congestive hepatomegaly, lower extremity edema, etc.)
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 +0  upvote downvote
submitted by lubdub(14)
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Symptoms of Right heart failure, right heart heave... and it's systolic, so gotta be tricuspid regurge.

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