Organ System Pathology USMLE Step 1 Practice Question
A 48 year old man presents with palpitations and awareness of a forceful heartbeat. He recently recovered from infective endocarditis. Blood pressure is 162/54 mm Hg. Examination shows head bobbing, bounding peripheral pulses, and a high pitched early diastolic decrescendo murmur heard best along the left sternal border when leaning forward in held expiration. Which of the following best explains this patient's widened pulse pressure?
Answer choices
- ALeft to right shunting across the atrial septum
- BFixed obstruction to left ventricular outflow during systole
- CImpaired right ventricular filling during diastole
- DReduced diastolic arterial pressure due to backflow into the left ventricleCorrect answer
- EDelayed closure of the pulmonic valve
- FIncreased systolic arterial pressure due to enhanced left ventricular contractility
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