Answer :USMLE step 2 Mcq 320:26 year old female had rheumatic fever as a child

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Correct Answer: D

Explanation:
diastolic rumbling murmur is heard with mitral stenosis Sometimes there is a middiastolic opening snap as well. A large v wave in the jugular pulse (choice a) is seen with tricuspid insufficiency.A systolic ejection murmur (choice b) is heard with aortic stenosis and pulmonic stenosis.The pulse pressure is the difference between systolic and diastolic pressure. An increased pulse pressure (choice c) is seen with aortic regurgitation.A pansystolic murmur (choice e) can be heard with mitral insufficiency


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