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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sFtir trahe dnuso 1()S is eaentgedr by wto htrea svelv:a het lirmta evlva nad iirducstp aev.lv lNeray inaeosutulms clgosni fo thees vlvase alrnoylm grestneea a lengis 1S nu.dso nttliSpig of het S1 sudno is aredh enhw tilamr nda iurpsicdt avelsv elsco ta hglyistl eedrnffti ,msiet iwht ualluys hte itlram cslgoin obfree ciisuptrd

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yotsubato hnTe yhw hte cfku is it idnrsicgeb a laimtr alevv dsuno in eht tsiudpric reaa +29

dr.xx 'sti icbreginsd a lsntpigit S1 — ssigcitnno of tramil nad uiptridsc valev scuelro — that is tseb ahred at het itiurpcds (eftl wrleo trlsnea rdorbe) nad rlmita ar(ciacd a)pxe ningsliet .sspto +40

titanesxvi crikyt iteoqs,un I tghuho twha dunso ti is in eht lfet netrlas dreb,ro os I cohse drtiupics evvl,a btu hwat tyhe where ngiska sa,w hwat si teh ftirs onnmotecp of the 1S snoud +5

titanesxvi cyritk es,qtoinu I uthohg ahwt nouds ti si in eht tefl seltrna ,deorrb os I sceoh pdcisitru ,vlvea ubt ahtw they erweh sagink was, thwa is teh tfsir ncmptonoe of eht 1S nsduo +1

drzed tI udlshn'ot rteatm ehwer uyo erah a spilt du.nos rFo mxel,pea on atemrt hwere oyu tucusaetla on eht earht, hte scnode taher unsdo ni a eayhhtl iddiuvlani iwll ysawla eb 2A ehnt 2P whreet(h ouy rea ta het tamirl iiltgesnn opts ro hte tcroia tniniegsl ehTsopt) eyk si iconizrgneg ttha teh hrigt sdeid avlevs ni eyltahh iddilvnasui iwll salwya oslec retal eg..( teh htrae dssonu era S1 S,2 but rmoe lcpfieiaylsc M1 1T 2A ).P2 The oesnra rof ihts is slimp:e if uoy aetk a earbht n,i uyo lilw sreienac dlpaeor on eht rithg ised fo hte he,rat dan uhts het grrtaee volemu wlli cuesa a ldaedye eucolsr fo teh vaev.l shiT si ilpsyohgoci in,ttislpg adn is ertteb edaippacetr in eht lomarupny dan oicrat vvesla ecsubae etyh rea eurdn teaerrg serrp,use and utsh erlu,od utb it anc aslo be rdaeh ni het ritsf hetar .nsuod +16

alexxxx30 sye egear!!d ishT tqnousei si sltyom sakgni if ouy nsradtnued a efw ibacs tshgni rgigendra ciorad s.yohip Teh lfet idse of het hreta si eht rghieh spsreeur dsie so ltef sedid velasv wlli clsoe ifs.tr Teh tgihr ised of hte aerth is het eworl eprursse se,id wchhi ensam irhgt dseid velsav lwil nope .istrf fte[L oecssl ,fstir Rhgit posne clS.sf,o]n..eiyrtd ti qruseier yuo ot okwn htwa S1 dna S2 sunods omce .rmof 1S is hte a/stdiulprctimri alvev golnics and S2 si the pumAcrrlo/yntaoi lsvvea lnc.ogsi So eyrlal eht noieqtsu sksa athw si het srfit ntmonpcoe fo 1S miarlt( or ucrtspidi essolc s)rfti. nAd snice we nkwo hatt hte fetl edis ilwl awylsa cesol ,isfrt it utms be atmlri eavvl lecs.uor rroSy if atht swa a gnol .atinpnoexla +16

jesusisking nTahsk xe0ax,xxl@3 oyu eth mna! PRI ebKo +

yesa @derdz lssnue 'ist aiacodxalrp pniltitgs ]xE aitroc sionsset, hten it is ctaroi vvael lgioncs trisf ta 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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submitted by ∗gh889(154)

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retGa ieovd on S1 nda si't t!s!ipl

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submitted by ∗rolubui(17)

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Teh ywa I bereemrm ,it S:1 itaMrl ;mp&a icuptdrsi cb lbood eosg ormf iraat ot litenrcvse enht orfm snctlivree ot iudoets teh heatr -t-g&; .2S ,oNw ewnh yuo vhae a Spilt S1 the yaw I nkith uobta is atth nhwe ouy iehnal you vaeh trxae bldoo iocmng toni hte rgith ised fo teh rteha so eth sirpctuid elvsav sslceo lrate nda assceu a pislt 1S puno oeps.rniarti epoH taht hspl.e

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+1 upvote downvote
submitted by ∗yogi(19)

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:Q Siptl S1 erhda orve efLt srnetla droreb - sctiidpru aea.r sFtir cpmnoeton of S1A:? gnynathi CM( ni RBBB) that cuaess eyldeda useorlc fo dsitrupic laevv cdparmeo ot ilmtar evval- ilwl cseau slitp S1 itwh laeeddy T1 dna larey 1M radhe at Tiidcpusr area.

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submitted by usmlehulk(7)

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ePlase adre eht slta entecsen fo teh un e.otiqs I nkith the lpits imght be bceeaus of ,b.bR shit seausc eht mtlria dan turiscipd levva ot secol at fetnidref is.mte

o-s wihch of eht owillgfno sbet ixesnapl eht rtsif oemnocntp of hte taerh sndou ip(lts 1.S) d Sohul be eth marlti avvle usercol oeerfb eth itdpuicrs eva.lv

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