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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Ftisr thear odsnu )(S1 si gtdneeear by two rtahe sevlav: het ltmrai eavvl dan drstiipcu evalv. eylraN samnstluueio gslcnio fo tseeh vaeslv anlromly nrgeatees a esnilg 1S su.don gtnlStpii of teh S1 unosd is rdeah wehn mratil nda picstiudr velvas eslco ta stgihlly ftfnreeid itm,se ihtw uullays hte mrailt lcosngi eobref cuptrdisi

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yotsubato hTne why eht fkuc si ti dnescribgi a tarmli lveva osnud in eth rtspicdui aare +29

dr.xx 'tsi ciensigbdr a iistlpgtn S1 — onistscgni of lramti dan tiisducrp avvle oeuclrs — ahtt is sebt edrah at hte updircits e(ltf eolrw latsenr rod)reb adn latmir aad(rcic pea)x ienlgsitn ssop.t +40

titanesxvi ikrcyt tuqeonis, I htough what sdnou ti is ni hte letf naetlrs eo,dbrr so I ehosc icdsriput ve,avl btu what hety rehew aksnig s,aw wath is hte fsrit moponcten fo eht 1S nosdu +5

titanesxvi ktryic ,nustieqo I uhothg htaw sondu ti si ni the eflt stalren obdr,er os I sehco rdiiuctps avlve, but wath ehty eewhr ksgian wsa, twha si hte tisfr pntoconem of het S1 ndsuo +1

drzed tI hdn'ultso trteam hrewe uyo aehr a tpils so.nud oFr ,examlep no attrem wereh ouy ltuucastae on the rth,ea hte dceons raeht ounsd ni a lhhatye ianuiidldv ilwl awasly eb A2 then P2 (werhteh uyo are ta eth martil nsiinlgte ptso ro teh cariot eigintlns To t)hsep yke is rgzcnngoiie taht eht girht ddsei lesavv in eahythl adsluindvii liwl aalswy slcoe ertla e(.g. eth heart nssduo ear S1 S2, ubt oerm pfiyllseccai M1 T1 A2 .P2) heT aorsen rof shti is slpemi: if you etka a ehbart ni, you llwi scaenrei aordpel no eth rithg desi fo hte a,tehr adn uhts the tgreear evuoml wlil aesuc a eyladed uolserc fo eth .evalv isTh is lsyhiicoogp gsttinpi,l nda si etretb eapipeacdrt ni the loaupnyrm adn ictrao aslvve ucsbeae yeht ear ednur gaerter pses,rrue dna uhst uerd,lo tbu it cna olas eb darhe ni het tfsir rhaet .dsoun +16

alexxxx30 yse d!a!gere hisT uqetiosn is ysmtlo isgank fi ouy duedsantnr a few sbcai hntsig rrgdgaein arcodi pysoih. Teh tfle desi of het rthea is hte hgheri seuresrp dies os tfel iddse elvvas liwl losec tf.isr eTh ihtrg sdei fo teh trahe si eth reowl srsuerep di,se cwihh nmsae ihgtr desid vesalv will npeo irs.ft t[eLf solecs ir,tsf Rthig snoep cySs..],fto.renlid it eqrirues you ot oknw athw 1S adn S2 dusnso mceo morf. 1S si eth ilaui/tdmtpcrirs vaelv icsgnlo nda 2S is the acnoAirrolmtu/yp saevlv loicsgn. oS lyeral het tienquos sksa tawh si hte rfits oeomtpcnn of S1 i(tlmra ro tpiircuds elossc si).rtf dAn eiscn we wnko atht teh flte idse ilwl aswyal loecs ifts,r ti msut be laimrt elavv rolc.eus yrroS fi that asw a ogln nxtlieo.apan +16

jesusisking hnasTk ,a0xlx3xxe@ uoy the !man PIR eKbo +

yesa r@zdde slsnue sit' acopdaxlria ntgipslti x]E oiatrc ,ssntseoi hnte it si coitar evalv snoigcl tifsr at S2. +

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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ertGa iovde on S1 dna s'it lips!t!

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+3 upvote downvote
submitted by ∗rolubui(17)

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Teh yaw I rmreembe ti, :S1 rtiMal amp&; iutdprsic bc lobod oseg rmfo traia ot nvteelsrci nhet ormf ncleeivrst to estoiud teh rahet ;-&-tg 2S. ,Now ewhn uyo hvea a ipStl S1 het ywa I htink buaot si tath ewhn oyu eliahn ouy ehva rteax oblod oignmc otin eth htrgi sied of teh eahrt os teh rtpidsicu savlev cosesl leatr nad csuaes a lptis S1 nupo ieapostrinr. pHeo htta hse.lp

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+1 upvote downvote
submitted by ∗yogi(19)

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Q: Stipl 1S rhade rove fteL rteasnl rrdeob - tuiicpsdr ar.ae irtFs moonpetnc of A ?1:S nnhtgiya C(M ni RBBB) that casesu elaeddy sluocer of ripcuitds vvela aromcdep to litmar a-vevl lliw ecsau tspli S1 iwth dleedya 1T dan laeyr 1M ahrde ta rTpuicdsi aa.re

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submitted by usmlehulk(7)

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Peelsa eadr the alts netsecen of eht squ.etoni I nhtik the itpls itmhg eb usbecea fo .R,bb isth scaseu teh tlamri nda pductisir vavel ot seclo at trdnfeife e.tmsi

-so hchwi fo eht giolwlnof sbet xseailpn teh tsfri ntpomcoen of the htrea suond istlp( .S1) d oSluh be hte tlmira veavl cesluor feeorb eth usprctidi lve.av

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