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Retired NBME Free 120 Answers

free120/Block 3/Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findings ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: cardio heart_sounds

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submitted by โˆ—bwdc(697)
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Iโ€™m going to point out that a normal healthy kid with no cardiac history or symptoms and no family history of sudden cardiac death for a pre-sports physical is probably going to have a benign exam no matter what you think you hear.

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the260guy  What a weird question. I could definitely hear a fixed split heart sound. And it was loudest over the pulmonic valve too which makes it even more of a dirty question. But I guess what I was actually hearing was an S3 heart sound. +16
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +18
angelaq11  don't have adobe and couldn't download it, so I just chose whatever, but your explanation suddenly makes me feel dumb but grateful! Loving your tips! @benwhite_dotcom +1
blah  @the260guy Have to agree with wutuwantbruv. I interpreted this as a physiological splitting, had the opportunity to hear it in a newborn as well. +4
prolific_pygophilic  Definitely S3. FA 2020 pg 287 "but can be normal in children, young adults, athletes, and pregnancy" +2
dhkahat  I swear to god it wasnt just during inspiration but what the hell do i know +
jbrito718  I thought I heard a "LOUD S2" but thats what happens when you read FA 30,000 times. +2
chaosawaits  I swear I had the volume to the max and couldn't hear shit. Then when I came back the second time to get the answers, it was working; but my dumb ass was hearing a skip beat. No dumbass, that's just the loop. +



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