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plz solve six Q (from NBME form 1) - kumkum
#11
Got that !
Thanks guru !
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#12
hoping4... why that diastolic sound cant be MS??
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#13
MS: it's MID-diastolic, and there's nothing to suggest that this man has MS (such as history of rheumatic fever)
S4: LATE diastolic (just b4 S1), and the history also suggests it: >10yrs HTN
causes of S4: forceful atrial contraction against a non-compliant ventricle, due to ventricular hypertrophy, aortic stenosis, HTN
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