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USMLE Q Bank Step 2 CK- 409




A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally.

What is the most likely diagnosis?

A-Mitral stenosis

B-Mitral regurgitation

C-Aortic stenosis

D-Aortic insufficiency

E-Pulmonic stenosis




Answer: 

This is a typical presentation of aortic stenosis with the typical murmur, mid systolic crescendo-decrescendo ejection murmur heard loudest at the second right intercostal space. Aortic stenosis causes low blood ejected to the carotids and eventually less blood to the brain, which causes transient loss of consciousness.

The correct answer is C






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