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NBME 20 Answers

nbme20/Block 1/Question#42 (36.0 difficulty score)
A 60-year-old man has two-pillow orthopnea, ...
Jugular venous pressure of 12 mm Hg🔍
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 +21 
submitted by yotsubato(965),
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Bfidi toaidrc pulses aer sene ni tiAocr nsetssio ro rnegtiiouratg

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chextra  I mis-remembered normal JVP as 8-12. Therefore, I picked "Slow-rising, decreased-volume carotid pulse". Is there a reason why this is NOT a result of HF, or is it simply not the best (which I agree is JVD)? +1  
len49  For those wondering normal JVP is 6-8 mmHg +3  
fatboyslim  @chextra I think the reason why it's NOT slow-rising decreased-volume carotid pulse (sign of aortic stenosis) is because the patient had a h/o prolonged substernal chest pain 5 days ago. I think he had an MI and is now presenting w/ heart failure. +  



 +8 
submitted by hayayah(1056),
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 +1 
submitted by scpomp(1),
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 +0 
submitted by dickass(83),
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Ptneait sha teclyua oeedpcstmndea aehtr a,eilfru omst elikyl edu to an IM 5 aysd ago. dsyOnpaoed-neheaam-trpe wludo anme eh lkyiel sloa sah rjlaugu nosuve stnoeinitd dan ctphaei isncoogn.te