Morning Quiz ☕️ 

A 36-year-old woman is brought to the emergency department with:

• Sudden-onset right-sided weakness

• Speech difficulty

History of Present Illness:

• Over the last 3 weeks, she experienced:

  • Progressive fatigue

  • Malaise

  • Low-grade fevers

• She did not seek medical attention or take any medications.

• Dental extraction 5 weeks ago 

Past Medical & Social History:

• No significant prior illnesses or hospitalizations.

• Works as a receptionist 

• No travel outside the U.S.

• No tobacco, alcohol, or illicit drug use.

Hospital Course:

• Admitted but dies 2 hours later despite resuscitative efforts.

Autopsy Findings:

• Large, friable, irregular masses attached to the atrial surface of a valve

Question:

Which of the following underlying conditions most likely predisposed this patient to developing these cardiac changes?

Answer Choices:

A. Atrial septal defect
B. Coronary artery disease
C. Hypertrophic cardiomyopathy
D. Mitral annular calcification
E. Regurgitant mitral valve prolapse

Correct Answer 🎯: E. Regurgitant mitral valve prolapse

36F → sudden R-sided weakness + aphasia + hx of 3-week low-grade fever, malaise, fatigue → hx of recent dental extraction (5 wks ago) → gross autopsy: large friable masses on atrial side of valve → died in hours despite resuscitation.

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Differential Table ⚖️

Visual Cheat Chart 📈 

Practice Questions ⏳️ 

Most Importantly Solve UWorld Questions with IDs:

8294, 232, 1983, 2074, 2075, 72, 7218, 230

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Dr. Shoaib Ahmad