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Old 09-07-2010
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Stethoscope Hard Question #4

A six year old girl comes to your office for her annual check up. On physical examination, you note a normal S1 and S2 as well as a soft systolic murmur with a vibratory character, heard best over the right upper sternal border. You suspect an innocent murmur, but her mother asks if she should be referred to a cardiologist.

Each of the following findings would support the diagnosis of a pathological murmur EXCEPT:

A. the murmur occurs in diastole
B. the murmur is associated with a thrill
C. the murmur is louder in the supine position and softer when the child sits upright
D. the child has mild finger clubbing
E. there is a loud P2 component of the second heart sound

????
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Old 09-08-2010
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C. the murmur is louder in the supine position and softer when the child sits upright...

nice Q...
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Old 09-08-2010
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C, is the answer.
thanks for the Q.
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Old 09-08-2010
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Excellent question - I know nothing about innocent murmurs - can someone explain the reasoning - ie: what happens to blood flow etc etc...
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Old 09-08-2010
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Default Innocent Murmurs

Excellent question - thnx - yeah .C. must be the answer ...

i think this link must help - about Innocent murmurs-

http://pediatriccardiology.uchicago..../htmurmurs.htm
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Old 09-08-2010
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Arrow Have a look

Just wrote this
Pathologic Versus Innocent Murmurs
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Old 09-09-2010
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Quote:
Originally Posted by Sabio View Post
Great stuff!
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Tags
Cardiovascular-, Clinical-Signs, Pathology-, Pediatrics-, Step-1-Questions

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