#april2020mccqe1
A 40-year-old woman comes to the physician because of a 6-month history of increasing respiratory difficulty that occurs during mild exercise, such as walking uphill. She is 165 cm (65 in) tall and weighs 58 kg (129 lb), but says that she has lost 4 kg (9 lb) over the past 3 months. Her blood pressure is 120/75 mm Hg, pulse is 85/min, and respirations are 16/min. Chest examination reveals crackles at both lung bases and a diastolic murmur near the cardiac apex. The characteristics of the murmur change with the patient’s position. Echocardiography reveals a solid mass that partially fills the left atrium and results in obstruction of the mitral flow. Which of the following is the most likely diagnosis?
(A) Fibroelastoma
(B) Metastasis
(C) Mural thrombus
(D) Myxoma
(E) Sarcoma
A 40-year-old woman comes to the physician because of a 6-month history of increasing respiratory difficulty that occurs during mild exercise, such as walking uphill. She is 165 cm (65 in) tall and weighs 58 kg (129 lb), but says that she has lost 4 kg (9 lb) over the past 3 months. Her blood pressure is 120/75 mm Hg, pulse is 85/min, and respirations are 16/min. Chest examination reveals crackles at both lung bases and a diastolic murmur near the cardiac apex. The characteristics of the murmur change with the patient’s position. Echocardiography reveals a solid mass that partially fills the left atrium and results in obstruction of the mitral flow. Which of the following is the most likely diagnosis?
(A) Fibroelastoma
(B) Metastasis
(C) Mural thrombus
(D) Myxoma
(E) Sarcoma
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