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NBME p2ck_form6 Answers

step2ck_form6/Block 1/Question#8 (6.0 difficulty score)
A 37-year-old woman comes to the physician ...
Pulmonary artery pressureπŸ”,πŸ“Ί

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submitted by sasoo8888(1),

I was confused why diastolic filling time wouldn't be correct. Hx of Mitral stenosis should mean that it takes longer for her left ventricle to fill up, right, so increased diastolic filling time?

tinylilron  you have a good point +1  
ronabobonafofona  I also thought this. But I knew for sure that Pulmonary artery pressure would go up, so I just went with what I was sure of. +  

submitted by sugaplum(376),

She is the classic demographic for pulmonary arterial hypertension. Slowly progressive disease. The PE findings support it

medicalmike  This patient's mitral opening snap and diastolic murmur are due to her mitral stenosis. Long-standing MS leads to elevated left atrial pressures which transmit to the pulmonary artery -> secondary pulmonary hypertension (not primary idiopathic PAH) +6  
ronabobonafofona  No worries @sugaplum. You've been right on for 99% of the other qs. +