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free120/Block 3/Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findings πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—benwhite_dotcom(622),
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mI’ gnigo ot tnoip tou tath a nmolra htyelah kdi ihtw no raadicc syothri or smtyspom dan no mfaiyl soyrtih fo duends rcacaid dahet rfo a porse-ptrs plishcay is boarbply niggo to aehv a inenbg exam on mettar hatw ouy nhkti uyo reah.

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. +15  
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +14  
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" +1  
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. +  
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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