NBME 23 Closure of the mitral valve (NBME Answers)

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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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rFtis rheta ndsuo 1(S) is tgdeearne by two ahtre se:lvva eth itrmal lveav adn rcisuipdt vlva.e lyrNae manielousuts soigncl of ehtse avevsl nmlyroal gtnesreea a neigls S1 odu.ns glStipnit fo the S1 usndo is draeh henw iratml dan pirtsdcui vesvla cleso at gyhtlsli fneetifdr iems,t with syluaul the rmlait glsiocn eferob ipdiusrct

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yotsubato hnTe why eht fcuk si ti inedrbiscg a aitrml vaevl sduno in teh utpricdsi arae +29

dr.xx ts'i ignedsirbc a gsintltip S1 — cnigsnitso fo ltrima nda dsctiruip velva corlsue — ttah si tseb hrdea ta teh ridiucpts lt(fe lwroe tarelsn r)ebord nad imtrla ccdia(ra xap)e lnseiintg p.ssot +40

titanesxvi trycki qstuon,ei I utghoh hatw undso it is in teh flte asntrel robder, os I shoce citprduis lavv,e ubt tawh tyeh rhwee kiansg sw,a wtah is the iftrs oocnmetnp fo eht 1S dunos +5

titanesxvi kcirty e,stquoin I ohugth ahwt nduso it is ni het etfl relatsn errbdo, os I cseoh dpciirstu eavv,l tbu ahtw htye rheew nakgis a,sw ahwt si eht tisfr ootcmepnn fo the 1S dsonu +1

drzed It uon'tlsdh emttar ehrew uoy earh a tpsli dnosu. oFr lax,eemp no emtatr wehre yuo csaeluutat on eht ,haret teh onecds eatrh sdoun ni a ahlyeht uvdiidanil wlli ywlasa be A2 then P2 hret(ehw uoy rae at eth mratli isntilnge otps ro the rtocai lenngtisi ost)hp eT kye is igngconzeri ttha hte rgtih edsdi evavsl in hlathey disadlivnui lliw ywaals ocsle trale e..(g hte aterh unsdso are S1 2,S utb omre ylpeclcaifis M1 1T A2 2)P. Teh eansro ofr hist si i:mslep if you kaet a tebrah ,ni ouy lwli sneercai rdaeolp on teh igrht idse of hte ehr,ta nad hsut het aertrge emuovl iwll auesc a lyddeae selourc fo the vaelv. Tshi is ihogypoclis iits,pntgl nad si etbret dcitaereapp ni hte lmponaury adn cotrai svlaev seeubca etyh rae nrdeu rtargee usrpe,ser nad huts ldruoe, ubt ti acn sloa eb aerdh in teh rsfti thrae uonds. +16

alexxxx30 sye dgre!ae! ishT uitenqos is oylsmt ikagns fi uyo ntersddanu a wfe abics ntsghi iedarggrn airodc ip.syoh heT flet deis of teh trhae is het hrgihe ssprreeu edis so elft ddise vvsale wlil escol t.fris ehT ghitr isde fo het rthea si the rwloe speeursr sdi,e cwihh sanme ihgrt eidds elvsav llwi eopn isftr. [tfLe seoslc sifr,t Rtigh peosn dln.ir.e,f.cSsoyt] it iequrser you ot kwon twha S1 and 2S sodusn cemo morf. 1S si het tiaridl/trcimpsu veavl osiglcn nad S2 is hte oAapt/icrumyolrn vlasev noi.gscl oS reyall teh uentosqi sksa wtha si eht sfirt tpmeconon of 1S mta(lri ro isirdtcpu csselo fs.tri) nAd nceis we konw thta het tlfe esdi llwi aalyws oecsl its,rf it tmus be tlairm lavve srelo.cu rSryo if ahtt saw a glon .naloitnaepx +16

jesusisking nsTkha lx3x,xx@a0e uoy eht am!n IPR bKoe +

yesa ezr@dd esnlus i'ts rcadalxipao ntipiglts xE] rotaci stosnes,i enth it si aritoc eavvl ilncsgo frsit ta 2.S +

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)

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+4 upvote downvote
submitted by ∗gh889(154)

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rtaGe iedov on S1 nda si't !tsi!pl

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+3 upvote downvote
submitted by ∗rolubui(17)

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ehT ywa I mrbereme t,i 1:S itlMra pam;& pdicurits cb odbol esgo mfor iaatr to snrevtclie etnh mrfo clvteerisn to utoides het aehtr -&g-t; 2.S o,Nw when ouy aveh a plSti S1 hte yaw I tknhi tboua si thta enhw yuo aienlh yuo ehav txare boold igomnc onti hte irght dsei fo eht hater so eth diiptsucr vvseal olcess tearl dna sscuae a silpt 1S poun aenrisi.orpt opeH that s.ephl

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: Slpti S1 herda evro Ltfe talsenr edrbro - dirpsiutc reaa. rFist npectnoom of 1:?A S naitnyhg MC( ni RBB)B ttah ssaeuc eydelad rcolues fo rudiicpts evlva rmepcdoa ot lriamt -avelv llwi easuc pltsi S1 hwti dalyede T1 nda lreay 1M dhera ta Tiiscpudr reaa.

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+1 upvote downvote
submitted by usmlehulk(7)

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Paelse drea eht stal seetcnne of hte o.stu nieq I nkith teh tslpi mthig be aeeuscb of Rb,.b sthi uasces eht mlarit dna icsdritpu elvav to elsoc ta firfneetd m.eits

-os wchih of the wfolgniol steb iesnalpx the rifst mcetpnnoo fo eth aerht nduso sp(til .1S) uohSd l be eth itarlm velva uelrsco ofbere hte tpiudcisr a.evlv

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