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  1. #1
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Pathology murmurs

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    A 25-year-old pregnant woman is referred to you for evaluation of a heart murmur that was noted during the second trimester of this pregnancy, which is her first. The patient has no history of cardiovascular disease, and the murmur was not heard during previous medical evaluations. She is asymptomatic. Examination shows a mildly displaced apical impulse and lower extremity edema. S1 and S2 are normal, and S3 is noted at the apex. A grade 2/6 early to mid-peaking systolic murmur is audible at the left sternal border. Based on the patients history and physical findings, which of the following is the most likely cause of the murmur?
    A. Bicuspid aortic valve with mild to moderate stenosis
    B. Congenitally abnormal pulmonary valve with moderate stenosis
    C. Physiologic murmur related to pregnancy
    D. Mitral valve regurgitation related to mitral valve prolapse
    E. Bicuspid aortic valve with moderate regurgitation
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  2. #2
    georgekiwa is offline Newbie 510 points
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    makerere university medical sch , kampala, uganda

    C. Physiologic murmur related to pregnancy

  3. #3
    Dr. X's Avatar
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    1-2/6 is innocent murmur, 1-3/6 is functional m., 1-6/6 is pathologic m. I would say physiologic as well.

    Lets say the murmur is 4/6 sys. murmur and delete the part that says left sternal border.. now try to answer the q.
    Last edited by Dr. X; 12-04-2007 at 06:32 PM.
    SJSM.

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    examprep is offline Newbie 510 points
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    A. bicuspid aortic valve with stenosis.

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