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Daily quiz: 2025/11/23
On November 23, the quiz focuses on distinguishing the characteristic harsh, high-pitched holosystolic murmur of ventricular septal defect (VSD).The murmur is loudest along the left sternal border and is accompanied by a palpable thrill. (November 23, 2025)

Daily quiz: 2025/11/22
On November 22, the quiz focuses on distinguishing the systolic ejection murmur characteristic of aortic stenosis (AS) from the murmur that radiates to the apex, known as the Gallavardin phenomenon.Pay close attention to the location of the point of maximal intensity and the direction of murmur radiation during auscultation. (November 22, 2025)

Daily quiz: 2025/11/21
On November 21, the quiz focuses on swallowing disorders in older adults.A key point is understanding silent aspiration, in which aspiration can occur even without coughing.Because aging and decreased swallowing reflex increase the risk of aspiration pneumonia, careful clinical observation is essential. (November 21, 2025)

Daily quiz: 2025/11/20
On November 20, the quiz asks you to identify the one adventitious lung sound that differs from the other three.You will distinguish coarse crackles from fine crackles by focusing on their sound quality and the phase of the respiratory cycle in which the crackles occur. (November 20, 2025)

Daily quiz: 2025/11/19
On November 19, the quiz features a patient who suddenly developed dyspnea.The patient presents with unilateral decreased breath sounds and subcutaneous emphysema.The quiz highlights the importance of recognizing the potential progression to tension pneumothorax, as well as proper positioning and close monitoring. Please listen to the breath sounds on iPax before answering. (November 19, 2025)

Daily quiz: 2025/11/18
On November 18, the quiz focuses on systolic heart murmurs.　First, you will identify the point of maximal intensity of the murmur.　Then, you will divide systole into three phases—early, mid, and late—and determine in which phase the murmur is heard. (November 18, 2025)

Daily quiz: 2025/11/17
On November 17, we will learn about the summation gallop, a finding seen during the exacerbation of heart failure. Due to tachycardia, the diastolic phase shortens, causing S3 and S4 to merge into a single low-pitched gallop sound. By listening to the actual audio, you will deepen your understanding of this important sign that suggests severe heart failure. (November 17, 2025)

Daily quiz: 2025/11/16
On November 16, the quiz focuses on how the second heart sound (S2) changes between inspiration and expiration.　By listening to the actual sounds, you will gain a clear understanding of the mechanism of physiological S2 splitting. (November 16, 2025)

Daily quiz: 2025/11/15
On November 15, we will learn about the characteristic changes in heart murmurs seen in Hypertrophic Obstructive Cardiomyopathy (HOCM). By listening to how murmur intensity varies with changes in preload, you will strengthen your ability to distinguish HOCM from other types of heart murmurs. (November 15, 2025)

Daily quiz: 2025/11/14
On November 14, the daily quiz features lung sounds from a home-care patient with heart failure. Based on typical findings seen during heart failure exacerbation—such as shortness of breath when lying down and pitting edema of the lower limbs—you will determine which lung sound corresponds to the one heard on iPax. (November 14, 2025)

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