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Daily quiz: 2025/11/25
On November 25, the quiz features a post–bioprosthetic mitral valve replacement patient who presents with a holosystolic murmur peaking in mid-systole, along with a diastolic opening snap and rumble.The quiz focuses on recognizing a mixed lesion of mitral regurgitation due to prosthetic valve dysfunction. (November 25, 2025)

Daily quiz: 2025/11/24
On November 24, we present the case of a 62-year-old man who developed shortness of breath when climbing stairs and showed a widened pulse pressure (168/50 mmHg).A blowing murmur beginning immediately after S2 was heard in Erb’s area, suggesting aortic regurgitation (AR).This quiz asks you to select the AR murmur from the three provided heart sound samples. (November 24, 2025)

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)

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