USMLE Step 3 - Question 11

A 71 year old female with a history of tobacco use, diabetes mellitus, rheumatoid arthritis, breast cancer is seen by her primary care physician for a routine follow-up visit. She has been feeling generally weak. She can only walk about 1/2 block before getting short of breath and dizzy. She denies chest pain. Her blood pressure is 90/60, heart rate 90, respirations 20, and she is afebrile. Her physical examination reveals normal breath sounds and no cardiac murmurs but heart sounds are distant. Her chest x-ray is below. What is her most likely diagnosis?

Step2-Q6-PIC1

A. Pericardial effusion

B. Congestive heart failure

C. Pulmonary hypertension

D. Mitral valve stenosis

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