WorksheetsMedical Case-Based Multiple Choice Questions
Total questions: 87
Worksheet time: 44mins
What is the reason of dyspnea in the pathology of cardiovascular system?
Congestion in portal vein
Spasm of the pulmonary arteries
Increased irritation of the respiratory center
Venous congestion in the pulmonary circulation
Venous congestion in the systemic circulation
What is the reason of enlargement of liver size in cardiovascular pathology?
Pulmonary spasm
Coronary artery spasm
Congestion in the pulmonary circulation
Congestion in systemic circulation
Circulatory disorders in the abdominal organs
What is the reason of edema in the pathology of the cardiovascular system?
Coronary spasm
Pulmonary spasm
Congestion in the pulmonary circulation
Congestion in systemic circulation
Circulatory disorders in the abdominal organs
THE pronounced pulsation along the left edge of the sternum in the epigastric area due to hypertrophy and dilatation of the right ventricle is called
Apex beat
Capillary pulse
Heart beat
Carotid shudder
Heart hump
What is the best method for detecting the “cat purr” symptom?
Inquiry
Inspection
Palpation
Percussion
Auscultation
What is the reason for the shift of the border of the relative dullness of the heart to the right?
Aortic aneurysm
Left atrial enlargement
Low standing of the diaphragm
Expansion of the cone of the pulmonary trunk
Dilation of the right atrium and right ventricle
Which of the following options is the zone of the best listening to sound phenomena associated with the work of the mitral valve?
Zone of the apical impulse
Base of the xiphoid process
2nd intercostal space to the left of the sternum
2nd intercostal space to the right of the sternum
Place of attachment of 3-4 ribs at the left edge of the sternum
The accent of the 2nd tone above the aorta is noted by
hypertension in the pulmonary circulation
impaired circulation in the lungs
increased pressure in the aorta
pulmonary stenosis
mitral stenosis
A man, 37 years old, passed medical examination with the aim of job placement. He had no complaints, as always considered himself healthy. But on the EchoCG, aortic insufficiency was detected. In the examination, doctor determined the shift of apical impulse and left border of heart to the right. Auscultative indices of this pathology:
systolic murmur on the apex, conducted into axillary region
on aorta systolic murmur, conducted to cervical vessels
diastolic murmur on aorta and in 5th auscultation point
1st tone strengthening on the apex
2nd tone accent on aorta
A 42-year old woman went to her family doctor with complaints about edemas on legs in the evening for about a month. In the anamnesis: one month prior to that she had influenza, treated herself without assistance using herbal decoctions. No other complaints. Which MOST PROBABLE cause of edemas development presumably could think the doctor?
Renal diseases
Allergic processes
Cardiac insufficiency
Pulmonary heart
Circulatory collapse
In a patient at night suddenly occurred cough with scanty mucoid sputum discharge and suffocation. In the examination by family doctor, acrocyanosis, orthopnea, harsh breathing, single dry rales, and in posterior-lower parts of lungs, moist rales were detected. Determine MOST PROBABLE cause of this clinic situation?
Inflammatory syndrome
Asthma attack
Disturbed bronchial conductance
Syndrome of pulmonary cavity formation
Congestion in the lesser circulation
In a patient, being on the inpatient treatment due to arterial hypertension, suddenly occurred severe asthma, cough with hardly discharged sputum, cold sweat, general weakness. At the examination – patient stood, pale skin with cyanotic tint. Over the lungs surface, diffuse dry and moist rales are heard. Heart tones are weakened. 2nd tone on pulmonary trunk is strengthened. Which MOST PROBABLE syndrome developed in a patient?
Acute respiratory failure
Myocardial infarction
Bronchospasm syndrome
Sharp increase of arterial pressure
Acute left ventricular failure
A patient, 23 years old, two weeks ago suffered angina, and after that, dyspnea and palpitation started to bother him. In the examination, doctor determined the apical impulse and left border of heart in 5th intercostal space. On EchoCG mitral valve insufficiency was detected. Which MOST probable data the doctor will obtain using auscultation?
Diastolic murmur on aorta, conducted to cervical vessels
Systolic murmur on the apex, conducted into axillary zone
Limited systolic murmur on aorta
Limited diastolic murmur on the apex
Limited systolic murmur on the apex
14. Into clinic was delivered a woman, 49 years old, with complaints against constricting pains in heart area, accompanied by headaches, palpitation and dyspnea. In anamnesis – she denies any diseases and injuries, suffered earlier, but notices that in the last year a menstrual cycle disturbance appeared – it became irregular. In the examination – there is a shift of the left border of heart to the left; heart tones are muted, weakened 1st tone on the apex and accent of 2nd one on aorta. PS-98’; AP – 150/100 mmHg. Which MOST probable pathology is present in this case?
Chronic coronary insufficiency syndrome
Acute coronary insufficiency syndrome
Aortic insufficiency
Arterial hypertension syndrome
Aortic stenosis
Young man, 23-year old, went to admission room of a clinic with complaints against dyspnea, palpitation after regular physical stress. These complaints bother him about a year. He can not indicate a possible reason, but notices frequent cold diseases. At the examination, left ventricular hypertrophy was found.. Which of pathological states, listed below, is MOST probable cause of this change?
Pulmonary artery stenosis
Mitral stenosis
Tricuspid stenosis
Mitral incompetence
Tricuspid insufficiency
A woman, 37 years old, went to district doctor with complaints against occasional headaches, occurring after emotional stress. After performed questioning and examination, her family doctor concluded that this woman has stage 1 arterial hypertension. Which of listed signs is most typical to this stage of arterial hypertension?
Steady BP increase
Transitory BP increase
Arteriosclerosis on eye grounds
Left ventricular hypertrophy
Left auricular hypertrophy
A woman, 27 years old, went to family doctor with complaints against palpitation, dyspnea, bothering after housework. From anamnesis – these complaints occurred about 3 weeks ago after chronic tonsillitis exacerbation. At the examination – moderate paleness of face. Palpation – apical impulse is improved, slightly shifted to the left; percutory – left border of heart is located in 5th i/s on middle-clavicular line. Auscultation – 1st tone weakened on apex, 2nd tone moderately strengthened in 3rd point; on the apex – short systolic murmur, conducted to the left. PS-100’; AP – 90/60 mmHg.
Aortic valve insufficiency
Mitral valve insufficiency
Tricuspid stenosis
Aortic stenosis
Mitral stenosis
An adolescent, 19 years old, went with complaints about dizziness, pains in heart and palpitation to his family doctor. From anamnesis – these complaints bother him last 7 – 8 months and increase after prolonged physical work. In childhood he was registered on the books due to aortic insufficiency and knows that he has increased pressure, but cannot indicate maximal values. Which MOST probable AP modifications are typical to this defect?
Systolic pressure increases, and diastolic pressure decreases
Systolic pressure decreases, and diastolic pressure increases
Both systolic and diastolic pressure increase
Only diastolic pressure increases
Into admission room of a clinic was brought a woman, 59 years old. According to her daughter-in-law, woman for 10 – 12 years has increased arterial pressure, but wasn't registered in polyclinic, takes antihypertensives at her own, when her pressure increases. Today in the morning she complained of dyspnea. Sudden deterioration of health occurred about one hour before, suffocation, cough appeared. In the examination – cyanotic face, bubbling breathing and mass of coarse moist rales over the whole lungs surface. Which of named conditions most probably developed in a patient?
Acute left ventricular cardiac failure
Chronic left ventricular cardiac failure
Chronic right ventricular cardiac failure
Acute right ventricular failure
Acute right auricular failure
In a woman, 46 years old, with long-time case history of mitral valvular disease, which was delivered by the emergency team to admission room of the clinic, doctor determined signs of left auricular insufficiency. Which of symptoms, listed below, MOST correctly characterizes this conclusion?
Edema of shins, cough, asthma
Cough, hemoptysis, dyspnea, orthopnea
Hemoptysis, edema of shins, liver enlargement
Cardiac asthma, forced horizontal position
Forced horizontal position, edemas on legs, ascites
Family doctor examined systolic murmur in the second auscultation point in a man, 49 years old, with complaints against piercing pains in heart area, asthma. After performed thorough questioning and examination, he determined aortic stenosis. Which is most probable area of systolic murmur irradiation in this defect?
Base of xiphoid process
Left axilla
Botkin Erb's point
Pulmonary artery
Neck vessels
A short and quiet diastolic murmur at the apex of the heart developed at a patient with aortic valve insufficiency. What is the cause of the cardiac murmur?
The combination of mitral stenosis
Mitralization of valve defect
Graham-Still's murmur
Combination of aortic stenosis
Flint's functional murmur
Limited diastolic murmur amplifying to the end of the diastole is heard at the cardiac apex after the 2nd tone. What is the cause of diastolic murmur?
Mitral stenosis
Mitral valve insufficiency
Stenosis of aortic valve
Aortic valve insufficiency
Tricuspid valve insufficiency
Compression of large arterial trunks with aortic aneurysm, mediastinal tumor, sharply enlarged left atrium, change the characteristics of arterial pulse. Which of the following pulse characteristics is probable with these pathologies?
Pulsus dificiens
Pulsus filiformis
Pulsus differens
Pulsus plenus
Pulsus durus
Cardiogenic shock is developed in 52-year-old man with a myocardial infarction. Which of the following symptom is more specific for this complication of myocardial infarction?
Increase of circulating blood volume
Increase of blood pressure over 80/50 mm Hg
Increased urine output over 2000 ml
Lowering blood pressure below 80/50 mm Hg
Increased cardiac output
During examination of a 27-year-old young man with complaints of palpitations and dyspnea after the physical exercises, the physician found an increased apical impulse. What is the reason of this condition?
Hypertrophy of the right atrium
Hypertrophy of the right ventricle
Left atrial hypertrophy
Left ventricular hypertrophy
Left ventricular hypotrophy
What is the reason of the muffling of both heart sounds?
Thin chest wall
Myocardial infarction
The presence of a large cavity in the lung
Malignant tumor of the mediastinum
During the examination of a 67-year-old man with heart failure the low blood pressure were revealed. What kind of change of the 1st tone is possible in this situation?
Gain
Reduction
Three-membered rhythm
Without change
Bifurcation
For anemia, thyrotoxicosis and mitral insufficiency, most typical is such symptom as?
Flint's murmur
Graham Steell's murmur
diastolic murmur on the apex
systolic murmur on the apex
systolic murmur on the aorta
Most probable cause, leading to decrease of absolute dullness of heart?
Pulmonary emphysema
Lung atelectasis
Myocarditis
Fluid accumulation in pleural cavity
Fluid accumulation in pericardial cavity
Most probable cause of occurrence of true hepatic pulsation?
right ventricular failure
left ventricular failure
mitral valve insufficiency
tricuspid valve insufficiency
aortic insufficiency
Most typical signs of pulsus filiformis are
Abrupt weakening or absence of pulsation in one arm
Number of pulse waves is less than the number of heartbeats
Number of pulse waves is more than the number of heartbeats
Sharp decrease of pulse magnitude on both arms
Sharp increase of pulse magnitude on both arms
Which of listed auscultative signs is the most typical and common symptom for anemia, thyrotoxicosis and mitral valve insufficiency?
Diastolic murmur on the apex
Systolic murmur on the apex
Graham Steell's murmur
For functional murmurs is most typical?
rough
soft
irradiating
steady
prolonged
For pericardial friction rub most typical are following signs, as?
constant
limited
spreading
heard only in systole
heart in the zone of relative dullness
What pathology is indicated by a short-term feeling of compression behind the sternum when walking in a 37-year-old man?
arterial hypertension
acute coronary insufficiency
acute left ventricular insufficiency
acute right ventricular insufficiency
chronic left ventricular insufficiency
In a patient with arterial hypertension, suddenly appeared large bubbling rale over lungs, which is MOST typical for?
acute right ventricular insufficiency
chronic right ventricular insufficiency
chronic left ventricular insufficiency
chronic left auricular insufficiency
acute right auricular insufficiency
In a 39-year-old man on EchoCG aortic insufficiency was found, for which is MOST typical the auscultative pattern?
diastolic murmur on the apex, conducted to cervical vessels
on aorta, limited systolic murmur
in the 2nd point, diastolic murmur
systolic murmur on the apex
1st tone increase in the 2nd point
In a patient at night suddenly occurred cough with scanty mucoid sputum discharge and suffocation. In the examination by family doctor, acrocyanosis, orthopnea, harsh breathing, single dry rales, and in posterior-lower parts of lungs, noteless moist rales were detected. Determine most probable cause of this clinic situation?
Asthma attack
Inflammatory syndrome
Disturbed bronchial conductance
Syndrome of pulmonary cavity formation
Congestion in the pulmonary circulation
District doctor examined by the call a patient with asthma and weakness. Patient's position in bed: orthopnea, cyanotic coverlets with icteric tint, ascites, edemas, swelling of cervical veins, liver enlargement. About which pathological condition most probably could think the doctor?
Liver cirrhosis
Portal vein hypertension
Respiratory distress syndrome
Chronic right ventricular failure
Chronic left ventricular failure
At the examination of a 39-year old woman, redness in her cheeks with cyanotic tint was noticed, acrocyanosis of lips, fingertips and toes. For which of below listed heart diseases are most typical these signs?
Mitral insufficiency
Mitral valve stenosis
Aortic valves defects
Septic endocarditis
Tricuspid insufficiency
What is most typical to murmur in aortic stenosis?
Conducted into left axillary region
Improved in the position on left side
Conducted to carotids
Conducted nowhere
Improved in exhalation
The MOST likely cause of shortness of breath in the pathology of the circulatory system is:
Venous congestion in the pulmonary circulation
Spasm of the pulmonary arteries
Congestion in the portal vein
Increased irritation of the respiratory center
Venous congestion in the systemic circulation
In heart failure, the MOST probable cause of hepatomegaly?
Venous congestion in the systemic circulation
Spasm of the coronary arteries
Violation of mesenteric circulation
Spasm of mesenteric vessels
Venous congestion in the pulmonary circulation
With pathology of the cardiovascular system, among the reasons that led to the development of edema, is it the MOST probable?
Stagnation of blood in the pulmonary circulation
Stagnation of blood in the systemic circulation
Pulmonary vasospasm
Spasm of the coronary vessels
Violation of blood circulation in the abdominal organs
The face, neck, shoulder girdle swelling during compression of the superior vena cava is most likely called:
Hydrothorax
) Hydropericardium
Ascites
Anasarka
"Stokes collar"
Which of the following options is the MOST probable cause of the shift of the right border of the relative dullness of the heart to the right?
Aortic aneurysm
Increase in the left atrium
Low aperture setting
Expansion of the cone of the pulmonary trunk
Dilation of the right ventricle
THE ACCENT OF THE 2nd TONE OVER THE AORT IS NOTED WHEN:
Violation of blood circulation in the lungs
Hypertension in the pulmonary circulation
Pulmonary artery stenosis
Insufficiency of the aortic valve
Arterial hypertension
A patient with aortic valve insufficiency at the apex of the heart has a short and quiet diastolic murmur. The most likely cause of this noise is:
Combination of mitral stenosis
The mitralization of vice
Noise of Graham - Still
Combination of aortic stenosis
Flint's functional noise
At the apex of the heart, after the 2nd tone, a low-tone diastolic murmur is heard, increasing towards the end of diastole. What vice is it MOST typical for?
Mitral stenosis
Insufficiency of the mitral valve
Stenosis of the aortic opening
Insufficiency of the aortic valve
Insufficiency of the tricuspid valve
For what defect is the increased “flapping” 1st tone at the apex of the heart most typical?
Insufficiency of the mitral valve
Insufficiency of the tricuspid valve
Insufficiency of the aortic valve
Stenosis of the bicuspid valve
Stenosis of the orifice of the aorta
A positive venous pulse is MOST likely to be determined when:
Insufficiency of the mitral valve
Pulmonary hypertension
Insufficiency of the tricuspid valve
Insufficiency of the aortic valve
Stenosis of the aortic opening
For systolic murmur with stenosis of the aortic orifice, the following is most characteristic:
Is carried out in the left axillary region
Is performed on the carotid arteries
Not conducted anywhere
Strengthens on inspiration
Strengthens in the position on the left side
Which of the following options can be the MOST probable cause of increased murmur before systole in mitral stenosis?
Active atrial contraction
Slowing blood flow from the left atrium to the left ventricle
Stretching of the left atrium
Shortening the time of left ventricular systole
Distension of the left ventricle
FOR MITRAL INSUFFICIENCY FROM THE BELOW INDICATIONS ARE CHARACTERISTIC
aortic configuration
displacement of the left border of relative cardiac dullness to the left
diastolic murmur at the apex of the heart
accent II tone on the aorta
quail rhythm
FOR MITRAL STENOSIS CHARACTERISTIC
Musset symptom
systolic murmur at the Botkin-Erb point
enhanced apical impulse
capillary pulse
diastolic murmur at the apex of the heart
FOR INSUFFICIENCY OF THE AORTIC VALVE CHARACTERISTIC
increased diastolic pressure
systolic murmur at the Botkin-Erb point
increased pulse pressure
displacement of the upper border of relative cardiac dullness upward
accent 2 tones at the point of the aortic valve
FOR AORTIC VALVE INSUFFICIENCY
Musset symptom
pulsation of the cervical veins
strengthening of the I tone at the apex of the heart
systolic murmur at the Botkin-Erb point
small slow pulse
FOR AORTIC STENOSIS CHARACTERISTIC
enhanced apical impulse
Musset symptom
diastolic murmur at the Botkin-Erb point
mitral configuration of the heart
accent 2 tones at the point of the aortic valve
FOR ARTERIAL HYPERTENSION SYNDROME CHARACTERISTIC
dance of carotids
displacement of the left border of the heart to the left
diastolic murmur at the apex of the heart
Musset symptom
FOR CHRONIC CORONARY INSUFFICIENCY SYNDROME CHARACTERISTIC
tachycardia
canter rhythm
chest pain on exertion
orthopnea
swelling of the lower extremities
SYMPTOM CHARACTERISTIC FOR CHRONIC LEFT VENTRICULAR INSUFFICIENCY
ascites
swelling of the neck veins
pain in the right hypochondrium
shortness of breath on exertion
pasty shins by the end of the day
MANIFESTATION OF ACUTE VASCULAR INSUFFICIENCY
drop in blood pressure
orthopnea
gallop rhythm during auscultation of the heart
pulsus differens
pulsus durus
FOR THE SYNDROME OF ACUTE CORONARY INSUFFICIENCY CHARACTERISTIC
an attack of severe pain behind the sternum
drop in blood pressure
pulsus differens
pulsus durus
During percussion of the heart in a 26-year-old woman, the “mitral” configuration was determined. Which of the following signs of a change in the configuration of the heart is the MOST characteristic of this symptom?
Displacement of the left border to the left and right to the right with a smoothed "waist"
Offset to the left of the left border with an emphasized "waist"
Upward shift of the upper border and smoothing of the "waist"
"Triangular" shape with an emphasized "waist"
Offset to the right and downward of the right border underlined with the "waist"
MOST characteristic features of «Pulsus differens»
Solid, high and prancing heart rate
The number of pulse waves is greater than the number of heartbeats
The number of pulse waves is less than the number of heartbeats
A sharp decrease in the value of the pulse on both radial arteries
Weakening or absence of pulsation in one radial artery
The main components of the I heart sound are presented
Opening of the semilunar valves and oscillation of the vessel wall
Closure of the semilunar valves and atrial oscillation
Atrioventricular valve closure and ventricular oscillation
Atrioventricular valve opening and atrial wall oscillation
Closure of the semilunar valves and oscillation of the ventricles
A pronounced weakening of the I tone at the apex of the heart may be the result of
Extrasystolic heart contraction
Myogenic dilatation of the left ventricle
Tonogenic dilatation of the right ventricle
Pulmonary hypertension
Mitral stenosis
Accent II tone in the 2nd intercostal space to the left of the sternum is a consequence of
Arterial hypertension
Insufficiency of the aortic valve
Stenosis of the pulmonary valve
Insufficiency of the pulmonary valve
Pulmonary hypertension
Shortness of breath in patients with heart disease is due to
Bronchial obstruction due to smooth muscle spasm
Violation of elastic stretching of the lungs due to sclerotic changes
Irritation of the respiratory center by the end products of nitrogen metabolism
Edema of the alveolar walls due to increased hydrostatic pressure in the capillaries of the small circle
Accumulation of transudate in the alveoli due to a decrease in the oncotic pressure of blood plasma
A characteristic feature of dyspnea of cardiac origin
Increases when air pollutants enter the respiratory tract
Increased in orthopnea position
Strengthens horizontally
Decreases with inhalation of bronchodilators
Decreases with exercise
Typical anginal pain in chronic coronary insufficiency (stable angina) is caused by
Transient myocardial ischemia during exercise due to coronary obstruction of atherosclerotic genesis
Complete occlusion of the proximal coronary artery by a thrombus
Insufficient blood flow to the coronary arteries due to aortic stenosis
Persistent myocardial ischemia due to inflammatory lesions of the coronary arteries (coronaritis)
Thromboembolism of the coronary bed due to inflammatory lesions of the endocardium
What are the characteristic percussion signs of mitral stenosis?
Expansion of the vascular bundle
Boot-shaped heart configuration
Displacement of the left border of relative cardiac dullness to the left
Pronounced "waist of the heart"
Displacement of the upper border of relative cardiac dullness upward
In what pathological condition will there be the highest pressure gradient between the left ventricle and the aorta?
A. Aortic valve stenosis
B. Mitral valve stenosis
C. Insufficiency of the aortic valve
D. Arterial hypertension
E. Pulmonary hypertension
The symptom "carotid dance" is due to
High pressure gradient between the left ventricle and aorta
Kitaev's reflex
High pulse pressure
Atherosclerosis of the carotid arteries
Aortic valve stenosis
"Hepatic pulsation" in heart disease may be due to
Mitral insufficiency
Insufficiency of the tricuspid valve
Thrombosis of the inferior vena cava
Hepatic artery thrombosis
Tricuspid stenosis
The most specific marker of myocardial necrosis is
Typical anginal pain
The appearance of a "gallop rhythm" during auscultation of the heart
Increased AST levels in the blood
Increased cardiac troponin levels
Displacement of the ST segment on the ECG downward from the isoline
In a patient with a rough systolic murmur in the 2nd intercostal space to the right of the sternum and a high intensified apical impulse can be identified
Small filling, slow pulse
Mitral configuration of the heart
Musset symptom
Hepatic pulsation
Palpation revealed diastolic tremor in the apex of the heart. What will the percussion data be in this case?
Offset of the left border of relative dullness to the left
Displacement of the upper border of relative dullness upward
Boot-shaped heart shape
Pronounced "waist of the heart"
Reduction of the area of absolute cardiac dullness
What examination should be performed in a patient with anginal pain lasting more than 20 minutes and an elevation of the ST segment on the ECG?
Holter’s ECG monitoring
ECHO
Chest X-ray
Coronary angiography
CT of coronary arteries
A drop in the propulsive capacity of the heart in acute coronary syndrome will manifest itself
Increased cardiac troponin levels
Displacement of the ST segment on the ECG upward from the isoline
Cold clammy sweat and pale skin
chest pain lasting more than 20 minutes
The appearance of a fast jumping pulse
A distinctive feature of the I heart tone is
Appearance after a short pause
Higher timbre
Coincidence with carotid artery pulsation
Better listening in the 2nd right intercostal space
Better listening in the 2nd intercostal space on the left
What characteristic symptom can be detected in a patient who, during auscultation of the heart, listens to the "quail rhythm"?
Symptom of "cat's purr" at the apex of the heart
Rapid jumping pulse
Offset of the left border of relative dullness to the left
High pulse pressure
Systolic murmur on the vessels of the neck
Choose the correct statement from the following
I heart sound occurs during a period of rapid passive filling of the ventricles
II heart sound is due to oscillations of the walls of the great vessels during ventricular systole
II tone occurs during the isometric contraction of the ventricles
III heart sound is due to fluctuations of the ventricular myocardium in the phase of rapid passive filling
I heart sound is due to the opening of the atrioventricular valves and the oscillation of the ventricular myocardium
What do you expect to hear during auscultation of the heart in a patient with hepatomegaly and pulsation of the jugular veins?
Weakening of the I tone at the apex of the heart
Pronounced accent of the II tone in the 2nd intercostal space to the left of the sternum
Systolic murmur at the base of the xiphoid process
. Diastolic murmur at the Botkin-Erb point
Systolic murmur in the II intercostal space to the right of the sternum
On physical examination of a patient with acute coronary syndrome, it is most likely
Mitral configuration of the heart during percussion
Symptom "carotid dance"
Swelling of the legs
Diastolic tremor at the apex of the heart
Tachycardia and weakening of I tone at the apex of the heart
A 42-year-old man complains of dizziness. On examination, the skin is pale, the left border of the relative dullness of the heart is 2.0 cm outward from the mid-clavicular line, a pronounced symptom of systolic tremor in the 2nd intercostal space to the right of the sternum. Which of the following auscultatory phenomena is MOST likely in this patient?
Systolic murmur over the aorta
Diastolic murmur above the aorta
Systolic murmur at the apex
Diastolic murmur at the apex
Systolic murmur at the xiphoid process
