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NBME 18 Answers

nbme18/Block 2/Question#47 (reveal difficulty score)
A 2 month old boy is brought to the physician ...
ventricular septal defect πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—ergogenic22(378),
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He ash a wnod nad tou lu,pip scadeu by CN III la.yps isH azge is deu ot epoodsupn tnoiac fo eht erlalta erutcs nad oprisure lq;eoibu ssitpo deu to ieoraendvtn fo tervlao arepalbpe u.ieorpisss

eTh lyno ijryun detlis atth docul euacs a NC III yalsp si aryunems fo het PCA icspmseonrg het autooomcrrl

submitted by βˆ—cheesetouch(222),
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2 thomns lod /w ylitoloscsho SLLB rmurum -- YLON ltsishlooyco srmrmuu aer limrta rggreu, pdTcsirui erggur, VSD A PD - tnoicuuson imenhca leki rumurm

isaacyo94  But this was described as a BLOWING murmur. When I hear the buzzword BLOWING murmur, I think regurg. +1  
djeffs1  can someone remind me what the functional murmur would look like? +  
ih8payingfordis  Don't get distracted by "blowing" Holosystolic is the key here and from there you can get VSD because that's the most common congenital heart defect +1  

submitted by βˆ—an1(72),

Holosystolic: MR, TR, or VSD

Lower left sternal border (the left border is Erb's point, beneath that is the Tricuspid area) --> TR or VSD

Whats more common? VSD (by far!!)

If they had mentioned the mum having BPD or taking pills for a psych disorder, then TR could be a big contender.

submitted by βˆ—step7777(5),
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eTh anitlooc is whta peldhe em .uot teLf elwro restnal obdrer si .LV iMlatr erurgg owdul eb at ,aepx DPA wodul eb aeimhnc klie, tniactoorca owdlu vhae ekaw ildats xyeemitrt esi,plsmu dna nepatt emfarno aloev luodw be pepur eatlsnr .broedr heT ylno eimt ve'I evre derah fo iiducTrsp eiranrtogtgiu is with VIA,D hwihc I bduot si noggi on ithw teh 2 tomnh dlo byo ulness eht mom ash eth rotpinyspe to ohtos hmi up dan in that ecsa 'edh ybbolpar pretnse hiwt a evfre

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