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NBME 21 Answers

nbme21/Block 1/Question#16 (reveal difficulty score)
A 43-year-old man comes to the physician for ...
Aortic πŸ” / πŸ“Ί / 🌳
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 +46 
submitted by βˆ—hyoscyamine(58),
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AF gp 72.1 ooT chum oagniyontxe cna ueasc eerf iacladr gaadem ilgande to ityerntoahp fo rtaytmipure


 +37 
submitted by βˆ—mcl(641),
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eLdlabe RCX snhgwio toopinis fo fietdfren vsav.el

hyperfukus  this link is great! they're still kind of close together :( its so hard to tell for me w/o reference of the others +  
hyperfukus  this link is great! they're still kind of close together :( its so hard to tell for me w/o reference of the others +  
mannywillsee  So the way to differentiate Aortic valve from the others is by checking the lateral view, AV will be more medial than both tricuspid and mitral; tricuspid will be more anterior and mitral will be posterior while Pulmonary is doing its own thing +2  

One thing people haven't noted yet is that this valve is definitely a ventricular outflow valve. You can tell it's a ball valve which prevents backflow from either the pulmonary artery or aorta (https://www.researchgate.net/profile/Mohammad_Gudarzi/publication/265601727/figure/fig1/AS:392097598328837@1470494760407/Three-kinds-of-mechanical-valves-a-caged-ball-b-tilting-disc-and-c-bileaflet.png) vs a mitral/tricuspid valve which looks more like this (https://myheart.net/wp-content/uploads/2015/11/replacement-mitral-valves.jpg)

+3/- ibestalkinyo(53),


 +18 
submitted by βˆ—step1soon(48),
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eil:gavtyaosvdadoioulhsryas./t-e/-rpmcte/raek/lh

kLoo at heerw teh spucs era intpgoin β†’ swuadrp roehfeert ita.orc fi pcuss ewre owadndrw β†’ tneh matlri vvale dwulo eb het ihtrg eswanr

misterdoctor69  mitral valve would only have 2 cusps even if it were replaced though right?... +  
bbr  After staring at this for awhile, I wanted to elaborate on this to make it even clearer. The 3 areas that meet at a point would be the 3 cusps. These 3 flaps are going to get blown open. Means flow is from down to up. +4  



 +4 
submitted by βˆ—kentuckyfan(44),
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aortehn lnki I fdnuo hfluple




 +3 
submitted by βˆ—suckitnbme(217),
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I swa cksut wtebnee mlarit nad catior nda ntwe iwth iotacr bueaesc hte L elirvcetn skloo ,gleadrne yilsbops nitnigh tath eth ttepnia dah ioartc ssesin.ot

drzed  I went with aortic because it looks like the valve has three cusps, while the mitral valve should only have two. Incorrect logic? +3  
an1  I was stuck between aortic and mitral. Thought he looked like he might have kyphosis, assumed it was trying to make us think Marfan and went for mitral valve :( +  



 +0 
submitted by βˆ—nbaumgarten(0),
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ihsT amy eb wgn,ro tbu it laos oloks liek eh mya aevh hda riocta uerngtitroiag e.orefb ouY cna ese ahtt his hsa teLf iaVtcunrelr tlee.egnmrna

ali_hassan  honestly i just thought that he had an early valvular lesion (had surgery when he was 43) without any history of some sort of endocarditis etc.. could be he had bicuspid valve which needed replacing +  
ali_hassan  33* +  



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