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MMLU / A 31-year-old woman, gravida 3, para 2, who is at 32 weeks' gestation, is…

Problem

Answer published by the source. Consult the official source to check your work against its answer.

question

A 31-year-old woman, gravida 3, para 2, who is at 32 weeks' gestation, is admitted to the hospital because of a 1-week history of progressive dyspnea and wheezing. She says her heart is "racing" and she is coughing up a small amount of bloodstreaked sputum. Medical history is significant for hypothyroidism, for which she takes levothyroxine. An intravenous catheter is placed. Vital signs are temperature 36.9°C (98.4°F), pulse 132/min, respirations 32/min, and blood pressure 135/78 mm Hg. Pulse oximetry on 100% oxygen via nasal cannula shows an oxygen saturation of 92%. Auscultation of the lungs discloses decreased breath sounds at the bases with expiratory crackles bilaterally. Cardiac examination discloses an irregularly irregular rhythm, an indistinct point of maximal impulse, and a loud S1. A grade 3/6, low-pitched, diastolic, rumbling murmur is audible at the apex; a distinct snapping sound precedes the murmur. Fetal heart rate is 144/min. Which of the following is the most likely cause of the findings in this patient?

choices

  1. Chronic mitral regurgitation secondary to rheumatic heart disease
  2. Coarctation of the aorta
  3. Congenital aortic stenosis
  4. Mitral stenosis complicated by atrial fibrillation

subject

professional_medicine

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Source and history

task_id
ebe200d4-af6d-5965-b0eb-895cfc51fec7
task_key
all--test--ebe200d4-af6d-5965-b0eb-895cfc51fec7
task_revision_id
1
config / split
all / test

Official source

initial import