Match each clinical presentation and its associated physical examination findings with the most likely underlying structural or valvular cardiac pathology.
- Exertional syncope; auscultation reveals a late-peaking systolic murmur at the right second intercostal space and delayed carotid upstrokes.Severe Aortic Stenosis
- Worsening exertional dyspnea; auscultation reveals a blowing holosystolic murmur at the apex radiating to the axilla.Chronic Mitral Regurgitation
- Wide pulse pressure and bounding pulses; auscultation reveals a high-pitched, early diastolic decrescendo murmur at the left sternal border.Chronic Aortic Regurgitation
- Exertional chest pain; auscultation reveals a harsh systolic crescendo-decrescendo murmur at the left lower sternal border that becomes louder when moving from squatting to standing.Hypertrophic Cardiomyopathy
- Hemoptysis and progressive dyspnea; auscultation reveals a loud S1, an opening snap, and a low-pitched mid-diastolic rumble at the apex.Rheumatic Mitral Stenosis
Answer
The correct matches directly link the location, timing, and dynamic characteristics of the murmurs to their corresponding valvular or structural lesions.
Each clinical scenario contains specific, pathognomonic physical examination findings that point directly to one cardiac abnormality. The pairings accurately reflect these classic associations as routinely tested on the USMLE Step 2 CK exam.
Step-by-Step Solution
Key Concept
Clinical presentation and auscultatory findings of valvular heart diseases and structural cardiomyopathies
Estimated Time:1m 30s