NBME Step 2 CK Form 6 Pulmonary artery pressure (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#8 (reveal difficulty score)
A 37-year-old woman comes to the physician ...
Pulmonary artery pressure 🔍 / 📺 / 🌳 / 📖
tags: cardio pulm inc

+4 upvote downvote
submitted by sasoo8888(4)

get full access to all content ⋅ pick a username

I was confused why diastolic filling time wouldn't be correct. Hx of Mitral stenosis should mean that it takes longer for her left ventricle to fill up, right, so increased diastolic filling time?

get full access to all content ⋅ pick a username

tinylilron you have a good point +2

ronabobonafofona I also thought this. But I knew for sure that Pulmonary artery pressure would go up, so I just went with what I was sure of. +1

lubdub HR's fast. 100 bpm.. No time for filling there! The lack of filling time contributes to the pathology. +2

jlbae If I had the power to, I would dub lubdub the resident cardiologist of this forum. +4

+3 upvote downvote
submitted by ∗step_prep7(71)

get full access to all content ⋅ pick a username

Classic presentation of mitral stenosis on NBME exams (rheumatic heart disease, worse with pregnancy, murmur description with diastolic snap-murmur)
Over time, mitral stenosis will lead to increased pressures in the left atrium which will back up into the lungs and the right side of the heart, eventually leading to right-sided heart failure; this knowledge coupled with the right ventricular lift (which occurs because the RV experiences hypertrophy secondary to increased pulmonary artery pressure) points to elevated pulmonary artery pressure
Diastolic filling time decreased (takes longer for mitral valve to open) and LV end-diastolic pressure also decreased/normal because of less blood flow from LA to LV

https://step-prep.org/tutoring/

get full access to all content ⋅ pick a username

-1 upvote downvote
submitted by ∗sugaplum(487)

get full access to all content ⋅ pick a username

She is the classic demographic for pulmonary arterial hypertension. Slowly progressive disease. The PE findings support it

get full access to all content ⋅ pick a username

medicalmike This patient's mitral opening snap and diastolic murmur are due to her mitral stenosis. Long-standing MS leads to elevated left atrial pressures which transmit to the pulmonary artery -> secondary pulmonary hypertension (not primary idiopathic PAH) +10

ronabobonafofona No worries @sugaplum. You've been right on for 99% of the other qs. +2

Must-See Comments from step2ck_form6

szsnikaa on Germinal cell tumor
qfever on Glycogen storage disease, type II (Pompe's ...
sugaplum on Observation in the emergency department
sugaplum on Right vertebral
sugaplum on Patent ductus arteriosus
sugaplum on Borderline personality disorder
jlbae on An excess of very long chain fatty acids
carolebaskin on Gallstone ileus
medicalmike on Daily exercise program
carolebaskin on Pulmonary contusion
medicalmike on Wean from the ventilator
sugaplum on Right optic nerve
medicalmike on Obstruction of cerebrospinal fluid flow
derpymd on Observation in the emergency department