Rosh Emergency Medicine Practice Test

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Prepare for the Rosh Emergency Medicine Test. Enhance your knowledge with comprehensive quizzes, detailed explanations, and vital emergency medicine concepts. Beat the exam with confidence!

Each practice test/flash card set has 50 randomly selected questions from a bank of over 500. You'll get a new set of questions each time!

Practice this question and more.

Which type of murmur is best described as a loud first heart sound with an opening snap and low-pitched diastolic rumble?

A harsh crescendo-decrescendo systolic murmur
A holosystolic murmur heard over the apex of the heart radiating to the back
A loud first heart sound with an opening snap and low-pitched diastolic rumble
A midsystolic click followed by a high-pitched late systolic murmur at the cardiac apex

The correct answer is: A loud first heart sound with an opening snap and low-pitched diastolic rumble

The described murmur is characterized by a loud first heart sound, an opening snap, and a low-pitched diastolic rumble, which aligns perfectly with the features of a mitral stenosis murmur. In mitral stenosis, the stiffened mitral valve leaflets open with difficulty during diastole, leading to the distinct 'opening snap' after the second heart sound, followed by a rumbling sound that is best heard in the left lateral decubitus position. This rumble occurs due to turbulent blood flow across the narrowed valve, producing the classic low-pitched diastolic murmur associated with this condition. The other options describe different types of murmurs that do not correspond with the specific features mentioned in the question. Each type has its own unique characteristics that do not match the key elements of a loud first heart sound, an opening snap, and a low-pitched diastolic rumble. Therefore, option C stands out as the correct representation of the murmur in question, directly linking it to the pathophysiology of mitral stenosis.