USMLE-Rx Step 1 Qmax Challenge #1412

Check out today’s Step 1 Qmax Question Challenge.

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USMLE-Rx Step 1 Qmax Challenge #1412A 54-year-old African-American man dies in a motor vehicle crash and an autopsy is requested. His family states that he avoided routine care until recently. He was diagnosed with diabetes several months ago but did not adhere to his medication regimen. They add that a skin-lesion biopsy several weeks ago was positive for melanoma and was subsequently removed by Mohs surgery. During autopsy, the man’s heart is examined and noted to be abnormal.

What process would likely cause the findings seen in the gross transverse section shown in this image?

A. Aortic valve insufficiency
B. Atrial septal defect
C. Myocardial infarction
D. Pulmonary hypertension
E. Systemic hypertension


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19 thoughts on “USMLE-Rx Step 1 Qmax Challenge #1412”

  1. This is a typical presentation of LVH and out of the options A) & E) could be the possible causes.
    But I guess his avoidance of routine care might have left with undiagnosed systemic hypertension. Even, there are no risk factors present that might lead to AR.

    So,my answer would be E)

  2. And ThankYou #FirstAidTeam for publishing such wonderful, interesting questions. Refering them and answers along with the justification has really helped me in successfully clearing my USMLE Step1

    I’m mentioning it here because I am attempting my first post-result question.

  3. E but I need to review more slides on the subject because I also am leaning to A. So I will review and decide.

  4. E. concentric LVH secondary to increased afterload, most likely due to uncontrolled HTN (RF: African-American, male, age, DM)

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