#february2020mccqe1
A 40-year-old man presents to the physician because of exertional dyspnea of recent onset. The patient appears comfortable at rest but says that he becomes short of breath with minimal effort. His temperature is 37 C (98.6 F), blood pressure is 162/65 mm Hg, pulse is 92/min with a rapid rise and fall, and respirations are 15/min. Chest examination reveals a prominent and laterally displaced apical impulse. A soft diastolic decrescendo murmur is heard along the left sternal border. Bilateral crackles are present at the lung base. The liver is not palpable, and there is no sign of peripheral edema. Which of the following is the most likely diagnosis?
(A) Aortic insufficiency
(B) Aortic stenosis
(C) Hypertrophic obstructive cardiomyopathy
(D) Infective endocarditis
(E) Mitral stenosis
(F) Ventricular septal defect
A 40-year-old man presents to the physician because of exertional dyspnea of recent onset. The patient appears comfortable at rest but says that he becomes short of breath with minimal effort. His temperature is 37 C (98.6 F), blood pressure is 162/65 mm Hg, pulse is 92/min with a rapid rise and fall, and respirations are 15/min. Chest examination reveals a prominent and laterally displaced apical impulse. A soft diastolic decrescendo murmur is heard along the left sternal border. Bilateral crackles are present at the lung base. The liver is not palpable, and there is no sign of peripheral edema. Which of the following is the most likely diagnosis?
(A) Aortic insufficiency
(B) Aortic stenosis
(C) Hypertrophic obstructive cardiomyopathy
(D) Infective endocarditis
(E) Mitral stenosis
(F) Ventricular septal defect
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