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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stFri ahetr unods ()S1 is deentraeg yb wto rhaet avve:ls eth tliamr veavl adn scdruptii ve.lav lyreaN smasulitunoe scolgin of ethse vsvael moyllarn aeesgretn a gnelsi 1S d.osnu tSiltnigp fo teh 1S dousn si hraed enwh tmirla nda tdsicrpui esvavl elsco at lhgltisy irenetdff mi,est ithw llusyua eht lrmiat cngoils fboere psurcitid

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yotsubato nhTe ywh hte cukf si it decinrbgsi a rtlmai vlvea dsuno ni eht dispiutrc reaa +29

dr.xx i'ts diberngcsi a gplsntiit 1S — snticoigsn of mrltai dna pdciritus avlve rloecus — htat si ebst eahrd at eth ipsutricd flte( lwroe etrsaln brdroe) nda iltarm ca(cdari xe)ap sigenltni ps.ots +40

titanesxvi yictkr tosuineq, I hhtoug wtah usond it is in hte felt eatslnr ebod,rr os I cehos sipctrudi ,avelv btu awht yhet wehre nksaig sw,a twah is hte rtsfi cotnopmen fo the S1 donus +5

titanesxvi kciytr oti,suqen I tohugh ahwt dusno ti is ni the etfl lrtsena er,rdbo os I sehco csirtpudi veavl, btu waht teyh erehw inkgas w,as hatw si eth trsif pctoonnme of the S1 unosd +1

drzed tI sul'tdonh rmteta rwhee uoy rhae a psilt udno.s rFo xe,aemlp on trtaem rhewe oyu tsauaculte no the ,retha teh encsdo arteh dousn ni a thalhey ididavinul llwi walasy be A2 hent 2P wh(ereth uyo are at teh iamtrl tnnliegsi tosp or the coarti gtnelisni T)hptos e yek is zrngincgoei that eht hrtig ddeis aelvvs ni lhthyea dluivisinda lwli yalsaw ceslo aterl (g..e teh thrae usonds are 1S S2, btu more silfeyiclpac 1M 1T A2 P2). Teh orensa fro ihst is isep:ml fi you tkea a trebah i,n uoy iwll nisceera arepold no teh ihtgr esid fo teh ah,rte nad hstu eht tgerrea veloum lilw auecs a aleedyd rluesoc fo teh lavv.e Tsih is lhocsiyogpi it,gsnlpti adn si rbttee teaprcdeapi ni hte apynrmolu nda ortcia vslvae ceauseb hyte era endru eeagtrr sr,eeurps nad suth uolr,de tbu it cna also be hadre ni het tsrfi rahet doun.s +16

alexxxx30 yse e!a!egrd hTsi ouneqtis is tmlyso ikagsn fi uyo turaednsnd a wef saibc ghstni narigedrg ciardo spo.iyh Teh ftel isde fo the ahrte is eht hiergh seserupr dies so ltef iedsd selvva llwi scoel .tfsir Teh itrgh eisd of eth retah is hte erwlo eprsusre dsei, hiwhc asmen rhitg eidds avselv lliw onpe rstif. Lte[f elsocs srti,f gtRhi snepo ,ls]rce.ftoSydi..n it qusreier oyu ot nokw twah 1S adn 2S undsos cemo .frmo S1 is eth mrucaitidtlps/ir evavl gloncis nad S2 si teh irpctlouor/anmyA alvsve clngio.s So lrlyae the uoqtines saks thwa is eht rifts cmnoptnoe fo 1S (tailrm or istdpcuri eocsls f.)tirs dAn ecnis we knwo ttha teh telf sedi lwli ysawla oscel fsr,it ti utms be aimrlt vlvae lcourse. rroyS fi tath wsa a gnol otlnnp.ieaax +16

jesusisking shkanT 3x,xa0x@xel yuo hte amn! IPR Kbeo +

yesa zde@dr nsulse i'ts arpiladoaxc ngiptitsl ]xE cotira s,inestso nteh ti si rioact avvel igosnlc sitrf 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)

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+4 upvote downvote
submitted by ∗gh889(154)

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rateG devoi on S1 dna ti's !listp!

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+3 upvote downvote
submitted by ∗rolubui(17)

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ehT awy I reermmbe t,i :1S iMtlar &;apm piustidcr bc bdolo ogse rmfo iaatr to nlietercvs nteh ofrm vilscrnete ot ueidsot hte aterh &-gt-; .2S woN, hnew oyu heva a ipStl S1 teh awy I htink tubao is atht enhw yuo enailh yuo ehva eartx dlobo cimngo noti eht trihg iesd fo the thare os eth iistdcrpu sveavl soeslc alret dan seausc a lpits 1S noup saroirpni.et pHoe htat .elhps

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: tpSli S1 hedra over fetL rneatls rrodbe - uscdriipt ea.ra Ftris nctopmoen of ?1:SA nynthaig (CM in B)RBB atth scaseu daledye uloscer of rctidispu valev cdompaer to tralim v-veal ilwl eucas pslit 1S hitw lydaede 1T and reyal M1 hrade ta pdiTuisrc a.rae

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+1 upvote downvote
submitted by usmlehulk(7)

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lPaese erda hte tsla eestnnec fo teh ne .tqosiu I itkhn eht pitls thgmi be cesuabe fo .Rbb, sith usseac teh itlarm nad dtpciusir velav to ceols ta nreetffdi s.etmi

o-s hhiwc fo eht ognfwlloi tbes nasepixl teh sirft contpemno fo the arhte dnuos (tilps 1S.) uod Slh be teh mraitl lvvae cusrole eebrof the rucpsdiit .valev

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