<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE rdf:RDF[
	<!ENTITY rdf 'http://www.w3.org/1999/02/22-rdf-syntax-ns#'>
	<!ENTITY rdfs 'http://www.w3.org/2000/01/rdf-schema#'>
	<!ENTITY owl 'http://www.w3.org/2002/07/owl#'>
	<!ENTITY swivt 'http://semantic-mediawiki.org/swivt/1.0#'>
	<!ENTITY wiki 'https://www.wikidoc.org/index.php/Special:URIResolver/'>
	<!ENTITY category 'https://www.wikidoc.org/index.php/Special:URIResolver/Category-3A'>
	<!ENTITY property 'https://www.wikidoc.org/index.php/Special:URIResolver/Property-3A'>
	<!ENTITY wikiurl 'https://www.wikidoc.org/index.php/'>
]>

<rdf:RDF
	xmlns:rdf="&rdf;"
	xmlns:rdfs="&rdfs;"
	xmlns:owl ="&owl;"
	xmlns:swivt="&swivt;"
	xmlns:wiki="&wiki;"
	xmlns:category="&category;"
	xmlns:property="&property;">

	<owl:Ontology rdf:about="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0832">
		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T16:29:03+00:00</swivt:creationDate>
		<owl:imports rdf:resource="http://semantic-mediawiki.org/swivt/1.0"/>
	</owl:Ontology>
	<swivt:Subject rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/WBR0832">
		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3AWBRQuestion"/>
		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3APages_using_duplicate_arguments_in_template_calls"/>
		<rdfs:label>WBR0832</rdfs:label>
		<rdfs:isDefinedBy rdf:resource="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0832"/>
		<swivt:page rdf:resource="https://www.wikidoc.org/index.php/WBR0832"/>
		<swivt:wikiNamespace rdf:datatype="http://www.w3.org/2001/XMLSchema#integer">0</swivt:wikiNamespace>
		<swivt:wikiPageContentLanguage rdf:datatype="http://www.w3.org/2001/XMLSchema#string">en</swivt:wikiPageContentLanguage>
		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Valve repair surgery</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect''' Tightening of valve can be accomplished through valve repair but it is not the best initial treatment.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Beta blockers</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Beta blockers are the preferred initial treatment in a symptomatic patient with mitral valve prolapse.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Aspirin</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect''' Aspirin is the initial treatment of choice in myocardial infarction</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Warfarin</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect''' Warfarin is used for anticoagulation in patients after valve replacement. It is not the initial treatment in mitral valve prolapse</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">No treatment needed.</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect''' When mitral valve prolapse is asymptomatic, treatment may not be necessary, but when symptomatic beta blockers are used</property:AnswerEExp>
		<property:Approved rdf:resource="&wiki;Yes"/>
		<property:ExamType rdf:resource="&wiki;USMLE_Step_2_CK"/>
		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">The episodes described in the question are most likely associated with a panic attack. Panic attacks and palpitations accompanied by a mid-systolic click suggest mitral valve prolapse as the diagnosis in this patient. Mitral valve prolapse is mostly asymptomatic but sometimes presents with atypical chest pain, palpitations and panic attacks. Squatting and handgrip which increase left ventricular chamber size diminish the murmur of mitral valve prolapse. Conversely, valsalva maneuver or standing decrease venous return and thereby worsen the murmur. Beta blockers are the preferred initial treatment in a symptomatic patient with mitral valve prolapse.

'''Educational Objective:''' Symptomatic mitral valve prolapse presents with panic attacks, palpitations and atypical chest pain. Beta blockers are the mainstay of initial treatment.

'''References:''' Page 91, 92 Master the boards step 2 CK second edition.&lt;br/&gt;
'''Educational Objective:''' &lt;br/&gt;
'''References:'''</property:Explanation>
		<property:MainCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Internal medicine</property:MainCategory>
		<property:PageAuthor rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Neeraja Danda M.B.B.S</property:PageAuthor>
		<property:Page_has_default_form rdf:resource="&wiki;WBRQuestion"/>
		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 32-year-old female presents to the physician for concern over several “scary” episodes over the past two months.  During these episodes she reports feeling her heart race, nausea, difficulty breathing and numbness throughout her body.  Her pulse rate is 76/min, blood pressure is 110/70 mm hg and respiratory rate is 16/minute. Cardiac auscultation reveals a mid-systolic click with a murmur that decreases in intensity on hand grip. What is the best initial treatment for this patient’s symptoms?</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">B</property:RightAnswer>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Cardiovascular</property:SubCategory>
		<property:WBRKeyword rdf:resource="&wiki;Mitral_valve_prolapse"/>
		<property:WBRKeyword rdf:resource="&wiki;Beta_blockers"/>
		<property:WBRKeyword rdf:resource="&wiki;Panic_attack"/>
		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-28T01:49:24Z</swivt:wikiPageModificationDate>
		<property:Modification_date-23aux rdf:datatype="http://www.w3.org/2001/XMLSchema#double">2459150.5759722</property:Modification_date-23aux>
		<swivt:wikiPageSortKey rdf:datatype="http://www.w3.org/2001/XMLSchema#string">WBR0832</swivt:wikiPageSortKey>
	</swivt:Subject>
	<owl:DatatypeProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#creationDate" />
	<owl:Class rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3AWBRQuestion" />
	<owl:Class rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3APages_using_duplicate_arguments_in_template_calls" />
	<owl:ObjectProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#page" />
	<owl:DatatypeProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#wikiNamespace" />
	<owl:DatatypeProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#wikiPageContentLanguage" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerA" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerAExp" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerB" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerBExp" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerC" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerCExp" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerD" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerDExp" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerE" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AAnswerEExp" />
	<owl:ObjectProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AApproved" />
	<owl:ObjectProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AExamType" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AExplanation" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AMainCategory" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3APageAuthor" />
	<owl:ObjectProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3APage_has_default_form" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3APrompt" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3ARightAnswer" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3ASubCategory" />
	<owl:ObjectProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AWBRKeyword" />
	<owl:DatatypeProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#wikiPageModificationDate" />
	<owl:DatatypeProperty rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/Property-3AModification_date-23aux" />
	<owl:DatatypeProperty rdf:about="http://semantic-mediawiki.org/swivt/1.0#wikiPageSortKey" />
	<!-- Created by Semantic MediaWiki, https://www.semantic-mediawiki.org/ -->
</rdf:RDF>