07-21-2009, 10:38 PM
28. A 16-year-old girl is brought to the physician because of episodes of palpitations over the past 6 months. The episodes occur when she runs or plays basketball. She is otherwise asymptomatic. Her blood pressure is 124/46 mm Hg, pulse is 78/min, and respirations are 18/min. She weighs 55 kg (121 lb) and is 180 cm (71 in) tall. Her arm span is 188 cm (74 in), and the upper segment to lower segment ratio is 0.85. Her fingers appear long and are hyperextensible. A grade 4/6, early diastolic murmur is heard along the upper and middle left sternal border with radiation to the apex. Peripheral pulses are bounding. Which of the following is the most likely cause of these findings?
A) Aortic incompetence
B) Aortic stenosis
C) Mitral incompetence
D) Mitral stenosis
E) Pulmonary incompetence
F) Pulmonary stenosis
G) Tricuspid incompetence
H) Tricuspid stenosis
A) Aortic incompetence
B) Aortic stenosis
C) Mitral incompetence
D) Mitral stenosis
E) Pulmonary incompetence
F) Pulmonary stenosis
G) Tricuspid incompetence
H) Tricuspid stenosis