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Which diagnosis best explains this presentation?

A 76-year-old man presents with exertional syncope and chest discomfort. On examination there is a harsh crescendo-decrescendo systolic murmur loudest at the right upper sternal border radiating to the carotids.

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  • Basic Sciences
    ✅ Verified

    Foundational sciences underpinning clinical medicine.

    • Anatomy
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      Gross, microscopic, and radiologic anatomy.

    • Physiology
      ✅ Verified

      Normal organ function and homeostasis.

    • Biochemistry
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      Molecular pathways and metabolic disease.

    • Pathology
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      Mechanisms of disease and pathologic findings.

    • Pharmacology
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      Therapeutics, adverse effects, and mechanisms.

    • Microbiology
      ✅ Verified

      Bacteria, viruses, fungi, and parasites.

    • Immunology
      ✅ Verified

      Innate/adaptive immunity and immune disorders.

  • Clinical Medicine
    ✅ Verified

    Core organ system disciplines and clinical care.

    • Cardiology
      ✅ Verified

      Heart failure, ischemia, arrhythmias, and valvular disease.

    • Pulmonology
      ✅ Verified

      Respiratory physiology and pulmonary disease.

    • Gastroenterology
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      Digestive and hepatobiliary conditions.

    • Nephrology
      ✅ Verified

      Renal physiology, AKI, CKD, and electrolytes.

    • Endocrinology
      ✅ Verified

      Hormonal regulation and endocrine disease.

    • Neurology
      ✅ Verified

      CNS/PNS disease, stroke, seizures, and localization.

    • Hematology
      ✅ Verified

      Anemia, clotting, and blood disorders.

    • Oncology
      ✅ Verified

      Cancer biology and treatment.

    • Infectious Disease
      ✅ Verified

      Diagnostic and therapeutic approach to infections.

    • Rheumatology
      ✅ Verified

      Autoimmune and musculoskeletal inflammatory disease.

    • Dermatology
      ✅ Verified

      Skin disease and lesion recognition.

    • Psychiatry
      ✅ Verified

      Mood, psychotic, anxiety, and substance use disorders.

    • Pediatrics
      ✅ Verified

      Infant, child, and adolescent medicine.

    • Pregnancy, reproductive health, and gynecologic care.

    • Surgery
      ✅ Verified

      Perioperative management and surgical disease.

    • Emergency Medicine
      ✅ Verified

      Acute resuscitation and time-critical care.

  • Population Health
    ✅ Verified

    Evidence-based practice, ethics, and systems of care.

    • Epidemiology
      ✅ Verified

      Study design, bias, and clinical evidence appraisal.

    • Ethics
      ✅ Verified

      Medical ethics and professionalism.

    • Quality & Safety
      ✅ Verified

      Patient safety, QI, and systems practice.

Ready-to-run tests

Timed test

Internal Medicine Mini Test

Three mixed questions across cardiology, renal, and endocrine topics.

3 questions · 12 minutes