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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stirF arhte uosnd (1S) si edegntrea yb owt treha vlsaev: het riltma elavv dan ptrisciud lvvea. alryNe leonususmita coiglsn fo etshe vavles amyllonr neetrsgae a igsnle S1 nosd.u gntiipltS of eth S1 duson is aedhr ewnh tirmal nad rupciisdt lsavve loces at tlylihgs dtfnefrie iesmt, iwht lyuuals eht tialrm lgsicno eerofb uipsirctd

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yotsubato enhT hyw het ukfc is ti eiicsgnbrd a irlamt alvev snudo in eth drtciupsi aear +29

dr.xx sti' sircndbgei a sptlnigti 1S — ncssiigotn fo itmalr nad pctirusdi lavve reulocs — ttah is btes dhaer ta hte sucpiridt tlef( lowre stalrne roedr)b nad timlar ca(rcadi pa)xe glseintin tssp.o +40

titanesxvi rktyci ionqsu,et I othguh waht dousn ti si ni eht ltfe ltaersn b,redro so I oechs utisdrpci ,lavve tbu awth yhte hewer iaksng ws,a what is hte stfri otoemnpcn of eht S1 nudso +5

titanesxvi tcikry qnu,stoie I ohguth whta dnous ti is ni het flte nletars rerdo,b so I ohcse picsruidt avve,l ubt atwh eyth ehewr gisank ,asw tawh is eth rifst etpnmonoc fo hte S1 nudso +1

drzed tI dnlsuto'h atrmet wehre you aher a split snodu. orF alxpeme, on rmetta eewhr yuo utealtucsa no teh haetr, eth enscdo htera udons ni a thaeyhl daviuniild lilw wylaas be 2A hetn 2P ehwtrh(e uyo era at the arltmi nitselgin tops ro eht cairot tgeniilns h sToe)tp key is cigreozning atth eth griht ideds aselvv ni yhtlahe suilnidiadv lilw saywal coesl retal ..(eg het traeh dsosnu era S1 ,S2 ubt more iicafllycpes M1 T1 A2 P).2 hTe orenas orf iths si :pimles if ouy teak a tbraeh n,i uoy ilwl rsaieecn lapredo no het tighr sdie of the erat,h nda uhts the rtaeerg mvoule lliw uecas a dlyadee rlseouc fo eht la.vve Tish si pisgycilooh ,pitigtnls nda is tbrete rpapateedic in the ounlmypra nad toicra eavlsv cbeasue tyeh aer ndreu arrgeet rsesue,rp nda tshu roel,ud ubt ti nca aslo eb rahde in hte frtsi etahr ou.dsn +16

alexxxx30 esy !r!aeegd hsiT einuqtos si osmlty sagnki fi you rndusednat a efw aicsb ihgnst aigrgdrne icdora .opyshi ehT flet edis fo het taerh is the hhiger preeurss eids so ltef seidd vsvale lwil selco rsft.i ehT tigrh eids of the thrae is hte wleor rreeussp esid, which esman grtih deids lvvase lwli neop r.ftsi Lt[ef escsol t,sfri hRitg spone o,i.tcSefy.lsd.]rn it urqresei you ot wnok what 1S dna 2S sudnso cmeo mf.ro S1 is hte ldcutasir/mpirti vlvae oisgnlc dan 2S is eth lpnrimctu/oyAroa esvvla lnic.sgo oS arllye eth seotinqu skas awth si hte frits ocemtnnop fo S1 ltrma(i ro cdurispit leossc itsf)r. dAn iescn ew wnko htat eht ltef sied lwil salyaw ecslo f,stir it utms eb latrim lavev .ruscoel rySro fi hatt was a ngol aaptnxo.line +16

jesusisking asnThk a0xx3e@xl,x uoy eht !nam PIR oKeb +

yesa ddz@re ussnel its' daaailocrxp nttsiiplg xE] roatci seossitn, hnte ti is rtoica avevl ciongls rsfti at S.2 +

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)

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+4 upvote downvote
submitted by ∗gh889(154)

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teGra idveo no 1S adn t'si !!pltis

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+3 upvote downvote
submitted by ∗rolubui(17)

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ehT ywa I emmrbere ti, 1S: Mlrait apm&; purtsidci cb ldboo eosg form aaitr ot sletncvrie tneh mrfo reveslncit to etdisuo het traeh t&g;-- S.2 o,wN enhw oyu heva a ltipS S1 het awy I ikthn botau is ahtt ewhn yuo anhlei ouy heav rtxea dbloo omginc nito eht hritg esdi fo hte rteah so the ictsurdip elsvav cssoel lreat nad suasec a ptisl S1 poun n.eptraroiis pHoe taht .lhesp

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: ipSlt S1 eahdr erov etLf tearlns borrde - iupisrctd raa.e srFit teocnonpm fo 1 A?:S tignyahn M(C in )BRBB that csuesa yedlade crsoule of iripsdcut elvav modparce ot tiralm l-avve lwli ceaus tpisl 1S htiw yeedald T1 dna layer M1 rahed at csridipuT aaer.

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submitted by usmlehulk(7)

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lePaes edar the ltsa sceenent of eth oni s.qetu I nktih the pilst gmhti be uecseab fo bRb,. hsti casues teh mtilar adn tpuiidcsr vvela ot eolsc at finetfdre e.smit

o-s hiwch fo teh iwollgfno etbs xpelasni eht ristf etncpmono of teh aethr odusn (split S.1) odu lSh eb eth imrtla laevv eolcusr efbero eht rusiicdpt vel.va

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