Murmum + Carotid and Femoral Pulsation + Head Bobbing - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 02-17-2011
USMLE Forums Guru
 
Steps History: Step 1 Only
Posts: 487
Threads: 95
Thanked 1,463 Times in 357 Posts
Reputation: 1473
Stethoscope Murmum + Carotid and Femoral Pulsation + Head Bobbing

A 46-year-old patient is referred to the cardiology department after a primary care physician hears a murmur on cardiac auscultation. Physical examination reveals bounding femoral pulses and carotid pulsations that are accompanied by head-bobbing. This patient most likely suffers from:


A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid regurgitation
D. Mitral regurgitation
E. Aortic regurgitation
F. Pulmonary stenosis
Reply With Quote Quick reply to this message
The above post was thanked by:
ibukun (02-17-2011), Mondoshawan (02-17-2011)



  #2  
Old 02-17-2011
USMLE Forums Scout
 
Steps History: ---
Posts: 95
Threads: 30
Thanked 33 Times in 27 Posts
Reputation: 43
Arrow E is the answer!

The answer is E (Aortic Regur)
Reply With Quote Quick reply to this message
The above post was thanked by:
aktorque (02-17-2011), ibukun (02-17-2011), Mondoshawan (02-17-2011)
  #3  
Old 02-17-2011
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 590
Threads: 31
Thanked 1,232 Times in 411 Posts
Reputation: 1256
Default E.

I agree - de Musset's sign (systolic head-bobbing) and Corrigan's "water-hammer" bounding pulse also present in femoral aa → aortic regurgitation.
Reply With Quote Quick reply to this message
The above post was thanked by:
aktorque (02-17-2011)
 
  #4  
Old 02-17-2011
USMLE Forums Guru
 
Steps History: Step 1 Only
Posts: 487
Threads: 95
Thanked 1,463 Times in 357 Posts
Reputation: 1473
Arrow E) Aortic regurgitation

Very good guyz. The ans is E) Aortic regurgitation

This patient’s physical exam findings are classic for aortic regurgitation (AR). In patients with AR, there is a large left ventricular stroke volume (LVSV) a large regurgitant SV, and a large pulse pressure. The left ventricular end diastolic volume is also increased due to the incompetent aortic valve. Bounding femoral and carotid pulses marked by abrupt distention and quick collapse (“water-hammer” pulses - Mondoshawan mentioned above) are the result of the large pulse pressure. Some patients exhibit head-bobbing with carotid pulsations (de Musset sign - Mondoshawan mentioned above) due to transfer of momentum from the large left ventricular stroke volume (LVSV) to the head and neck.
Reply With Quote Quick reply to this message
The above post was thanked by:
conspicous (02-18-2011), ddaydreamer (02-22-2011), doctorsmonsters (02-17-2011), lokithachikkam (09-24-2015), Mondoshawan (02-17-2011), wimzie (02-18-2011)
  #5  
Old 02-17-2011
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 335
Threads: 24
Thanked 295 Times in 152 Posts
Reputation: 305
Default

I think I'm gonna start making notes from your posts aktorque!
Reply With Quote Quick reply to this message
The above post was thanked by:
aktorque (02-18-2011)



Reply

Tags
Cardiovascular-, Clinical-Signs, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Carotid Sinus to Medulla Pathway nicki USMLE Step 1 Forum 2 02-23-2011 11:41 AM
Carotid sheath dr z USMLE Step 1 Mnemonics 0 01-15-2011 02:31 PM
After femoral cath Ethar USMLE Step 2 CK Forum 2 09-27-2010 05:44 PM
CA of Head of Pancreas; Anatomy achistikbenny USMLE Step 1 Forum 8 05-29-2010 03:17 PM
Femoral Circuflex Arteries lee-usmle USMLE Step 1 Bits & Pieces 1 10-25-2009 08:16 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)