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Item 3 of 40
CARDIOVASCULAR PHYSIOLOGY

A 58-year-old man presents with progressive dyspnea on exertion and bilateral lower-extremity edema over the past 3 months. Exam shows jugular venous distension and a laterally displaced apical impulse. Echocardiography shows an ejection fraction of 30%. Which of the following best explains the mechanism of his lower-extremity edema?

Explanation

This is left-sided systolic heart failure (reduced EF). Impaired forward flow raises left atrial and pulmonary pressures, which back up into the venous system — increased hydrostatic pressure pushes fluid into the interstitium faster than lymphatics can return it, producing edema.

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Before you ask

Frequently asked

One subscription grants complete access to 10,000+ questions across all covered question banks (USMLE Step 1/2CK/3, AMC, UKMLA, SMLE) for 270 full days. You do not pay separate fees for individual exams.

We save your details and reach out using the phone number you gave, to confirm your 270-day pass and complete payment. You won't be charged on the registration page. Once your pass is confirmed, download the app and log in with your registered account.

Altruism is built cross-platform under the hood, but Windows is where it launched and operates today. You can register from any device, and use your account on up to 2 Windows machines.

Only for initial installation and periodic check-ins. Once downloaded, your question banks are stored and decrypted locally. You can answer questions, create custom tests, and review performance completely offline — you just need to connect once every 7 days to keep your license active.

Both options unlock the exact same 270-day all-access license. Paying online directly provides instant card processing. Paying through a local ambassador allows bank transfer or cash payment in your local currency.

Yes — each license covers up to 2 of your personal Windows devices (such as a primary desktop and laptop).