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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irsFt rathe dunos S1() is teenregda yb tow arthe se:alvv het ritaml vvael dan ctdisruip lv.ave alryeN ouaslsetumin igclsno of hetes alvves amllyrno stngreeea a egsnli S1 ns.oud ttSilnipg fo eth 1S dosun is dreha nhwe larmit nad icrdustip evslav seocl at sythlgli rdntiffee tim,se hwti uusllay eth raltim icnosgl erbeof rspidictu

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yotsubato hTne hwy the ckfu is ti igibcndrse a ratmli aelvv ousnd in eht suticrpdi aare +29

dr.xx tis' rcdneiisbg a pglistint S1 — sisignnotc of ralmti nda rcuidstpi eavlv rluscoe — hatt is ebst haedr ta the tpisirucd e(tfl olrew srentla rrob)ed dna mralti r(aaidcc )eapx tesnlnigi p.stso +40

titanesxvi yitckr tn,isueoq I hohugt hwta osudn ti si ni het flte trelnsa ,rrebod os I eohsc dtsirupci elavv, ubt atwh ythe erewh nsgaki ,asw hwta is the sitfr ptnoocmne fo eht S1 oduns +5

titanesxvi iykrtc ti,oequns I htghuo hatw snduo it is ni hte flte lrnetsa rode,rb os I hecso ciudrpits val,ev tub hwat hyte ewehr sanigk saw, tawh si the frits nonemtocp fo the S1 sdnuo +1

drzed tI 'hlsnutod emtatr rweeh yuo haer a listp .onsud Fro a,plmexe on ttemra rweeh yuo teaatucsul on hte e,trah teh sdnoec thera snoud in a eatlhhy ivdanluidi illw ayaslw be A2 hetn 2P rewthh(e uoy era at teh lramit ntilgisen spot ro eht tacrio tingnslei T)phsote eyk is geizcnrgino that eht htrig iesdd vlaesv in teyhhla sauvidinidl wlli aawsly olesc earlt .e.(g teh aethr sunsod rea 1S 2S, tub orme lifsycpciela M1 1T 2A P2). Teh aenosr rof stih is smpi:el if you take a eabthr i,n you iwll creaines eporlda no het ihtgr dsie of teh eh,atr nad tuhs eht gterrae lmueov wlil scuea a aldeeyd suroelc of eht .evlva hiTs si hsciolpygio tlipn,gsti nad is btetre ppatdreecai in eht naopmruly nad ticaor aevvls uecsaeb etyh ear urnde argtree re,preuss and thus rdelo,u tub it nca laos eb erhda ni eht sfirt heart nuos.d +16

alexxxx30 eys edrge!a! hisT onieqstu is mlotsy nsgiak fi uyo nurnteddas a wef asibc ghinst daggirenr dracio h.piosy eTh etlf deis of hte atrhe is het hhgeri pruesres ised so tfle esdid asvvel lwil sloce ritfs. ehT tighr dsie of het htrae is eth weolr rrespseu dei,s hcwhi snema rtigh ideds vevsla will epon s.firt f[teL slsoce ifrts, thigR posne y.tf]idc.lo.,seSrn ti iursereq ouy ot onwk hwta S1 dna S2 odusns meoc fmro. S1 is teh tpusdarct/ilmiri evlva gclosin adn 2S is eht rlna/yotruopcAim slveav g.lsocin oS yrlela het seuinoqt ksas twha is het fistr nomoetnpc fo S1 rmitl(a ro picitursd seoscl fr.is)t Adn snice ew wkno atht eth eltf ised lliw alayws cleos fsi,rt ti stmu be mlriat alvev elrusoc. orySr fi htta swa a ogln .ntieaaxnopl +16

jesusisking hnTkas xe,axxx03@l oyu het !amn RIP Kbeo +

yesa zde@dr elsusn tis' aoixdpalacr istltpign ]Ex tircoa nsei,tsos tehn ti is atirco vaelv iosnclg tsifr 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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Graet oeidv no 1S dan t'is i!l!pts

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+3 upvote downvote
submitted by ∗rolubui(17)

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eTh ywa I emrmereb i,t 1:S iratMl ma;&p dstpiircu cb bdloo eosg orfm iaatr ot trenlseciv neht mrof tsevenircl to iousdet the ahert g;-t-& 2S. wN,o henw yuo ehva a lpSit S1 eth ayw I itkhn oautb is that whne uyo lehani ouy vaeh rexta dloob coigmn otin hte rgthi seid fo teh rhtae os het usidcrtpi vsalve lecsos ralet dna suscea a iptls 1S ounp noistiea.prr poeH tath lshep.

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+1 upvote downvote
submitted by ∗yogi(19)

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:Q ipSlt 1S hreda rveo etLf tnrelas rbodre - ritcudspi rea.a Fsrit ptemncono of S?:A1 htgyinan C(M in BBB)R atth ussace yeddlea cueosrl of ctsprduii veval rcdoepma to lamrit -avlve wlli uasec lpist 1S tihw ddleeay 1T dan yrale 1M hrdea ta Tcdrusipi eara.

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+1 upvote downvote
submitted by usmlehulk(7)

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leaePs aedr teh ltsa snnectee of hte enti. qosu I htnki het tpsil gitmh be ucsaebe fo b.b,R sthi uscsea eht ltiarm dna riusdtcpi evval to elocs ta ieneftdfr mtsei.

os- chihw fo hte iloofglnw sbet slpiaxne the isftr coepmnotn fo teh hrtae odsun (tislp 1)S. S dlhou eb the mliatr aevvl cruseol feober teh tiipurcsd .lavve

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