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Retired NBME 15 Answers

nbme15/Block 4/Question#16 (reveal difficulty score)
A 7-month-old girl is brought to the ...
Coarctation of the aorta ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—djeffs1(18)
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I just want to know why the blood pressure is decreased..

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hiroshimi  For a 7 month old baby, the normal SBP is between 67-104 (the number is varies depending on the sources but generally around <105. So this baby BP is actually high normal. Another sign for coarctation is the decrease in the femoral pulse, and that tell you the differential. +2
whk123  Imp complications of COA: โ†‘ risk of Cerebral hemorrhage, HF, aortic rupture, and endocarditis. +
sirknit  Coarctation of the aorta often occurs distal to where the left subclavian artery branches off the aorta. The coarctation causes a decreased blood flow only to the lower body (so you'll see decreased femoral pulses, as in this case). If coarctation is located before the left subclavian branches off, then you could see lowered brachial pulse. +
sirknit  Edit to my subcomment: decreased left brachial pulse** +



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submitted by โˆ—dentist(94)
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"best heard in interscapular region" boom. coarc

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