Heart Murmur Question

[FeedTheHippo]

I have a question about heart murmurs, hope you guys can give me a definite answer.

When they ask a question about a murmur, for example, lets say in the stem they are asking about a murmur that is heard at the Apex of the heart. Immediately we know that is the area of the Mitral Valve, and the pathology is going to be a Mitral Regurg or Stenosis..
However, in First Aid, they mention many of the murmurs will radiate to a certain location. For example, an Aortic Stenosis (heard at the right 2nd), radiates to the Carotid and Apex. So my question is, if it radiates there, are they saying its heard there as well? On a question, can they technically be asking about an aortic stenosis and say its heard at the apex, since it radiates there? Or will they have to always mentioned it radiated there?

I hope you guys can see where this may be tricky. B/c when they say Apex, we immediatly think Mitral pathology, but if something radiates to the apex, does that mean we have to know it can also be heard there?

Thanks!

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[DrTacoElf]

I don't think their purpose is to trick you like you are talking about above. Yes they could do it but their main purpose is to be sure you know murmurs in the most classic presentation. So I would say apex would be mitral pathology most likely UNLESS they offer physical exam findings that suggest something else.

 

[kryptik]

agreed with the above, they dont try to trick you, so if its stated that its heard best in the apex its probably one of the mitral murmurs, the history also clues you in

check this post http://forums.studentdoctor.net/showpost.php?p=8301352&postcount=7

 

[jad2121]

I completely agree. So far, I havn't run into a murmur question that tricks you with the location. For me, the real tricky questions are the audio ones. I honestly can't even differentiate between a systolic and a diastolic murmur. Anyone have any tips?

 

[kryptik]

join the club, lately i dont even bother to listen to the audio, i try to answer from the stem and move on

 

[utdoc05]

funny thing is, I talked to a MS3 at my school today who did very well on step (260+) and he was saying for his murmur audio questions on the real thing, that u could listen to the audio at the 4 different sites and each sounded the same (not louder or different that he could tell). Also the history they gave was not helpful, he said he felt like he probably missed all 3. Just thought I would throw that out there, not sure if anyone else who has taken the test had the same experience or not