nbme 2 peds - beatit

[ArchivalUser]

I will go with ASD bc S2 is widely
split and does not vary with respiration , so do not vary with inspiration..
answer ASD
BBBBBB

[ArchivalUser]

I think u may be right, but I do belive that VSD can also have a wide S2 split that does not vary w/ Inspiration.
The Wide Split is d/t the fact that PUlm Vavle stays open longer b/c of the constant (hence Fixed) increase in blood flowing from L to R

I am just confused about the fact that there is a distolic M at the Lower Sternal Border??

VSD defect can be small, n stay open n not necessary n be ASx as well

[ArchivalUser]

I AM POSITIVE THAT THIS IS ASD...I ahve my friend pediatrician who just come sitting next to me an dhe CONFIRM taht this is classic ASD, now the diastolic murmur can be due to the possibility that ASD is extensive ,large enouph to caus emitral valve dysfynction and lead to mild regurg which will caus ediastolic murmur....
ASD!!!!!!!!!!!!!

[ArchivalUser]

BBBB

this is a typical ASD

systolic murmur is a flow murmur though pulmonic valve

mid diastolic murmur is a rumble through tricuspid valve bcoz of left to right shunt

other thing is wide and fixed splitting charateristic of ASD